Clinical and Reproductive Outcomes of Uterine Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP): A Tertiary Center Experience

Year 2023, Volume: 40 Issue: 4, 697 - 702, 03.01.2024

Serkan Akış , Uğur Kemal Öztürk , Sami Açar Erman Çiftçi , Murat Api

Abstract

Some smooth muscle tumors do not meet the histologic criteria for definite benign-malignant distinction and this rare group is thus classified as smooth muscle tumors of uncertain malignant potential (STUMP). Due to the high heterogeneity, there are no standard guidelines for the diagnosis, treatment, and follow-up of uterine STUMPs. So, we aimed to evaluate the treatment modalities in patients with/without fertility desires. The size, mitotic count, presence of necrosis and atypia of tumors were obtained from the final pathology reports. Patients were followed up with electronically merged records via telephone until October 2022. Recurrence, time to recurrence, and recurrence histopathology were included in the study. Myomectomy was performed in 50% of the patients. Frozen section was not considered necessary in 57.1% of all patients and 50% of the patients who underwent frozen section were reported as benign. Median follow-up was 64.5 months. tumor necrosis was observed in 14.3% patients. The median mitosis count was calculated as 2.5 (1-9) per 10 high-power fields. Recurrence rate was calculated to be 7.2%. The accuracy of a frozen section diagnosis may not always be reliable, it is often confirmed after the final pathology has been reported. Patients who desire fertility can be supported. Our research indicates that recurrence rates could be lower in centers where experienced pathologists are making the diagnosis.

Keywords

Fertility, leiomyoma, leiomyosarcoma, mitotic count, necrosis, recurrence

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