Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP): A Comprehensive Multidisciplinary Update

Author:

Tinelli Andrea1ORCID,D’Oria Ottavia2,Civino Emanuela3,Morciano Andrea4ORCID,Hashmi Atif Ali5ORCID,Baldini Giorgio Maria6ORCID,Stefanovic Radomir7,Malvasi Antonio8,Pecorella Giovanni9ORCID

Affiliation:

1. Department of Obstetrics and Gynecology and CERICSAL (CEntro di RIcerca Clinico SALentino), “Veris delli Ponti Hospital”, 73020 Scorrano, Italy

2. Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University, 00185 Rome, Italy

3. Department of Biological and Environmental Science and Technology, University of Salento, 73100 Lecce, Italy

4. Department of Gynaecology and Obstetrics, Pia Fondazione “Card. G. Panico”, 73039 Tricase, Italy

5. Department of Histopathology, Liaquat National Hospital and Medical College, Karachi 74800, Pakistan

6. MOMO’ FertiLIFE, 76011 Bisceglie, Italy

7. Department of Histopathology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia

8. Department of Biomedical Sciences and Human Oncology, University of Bari, 70121 Bari, Italy

9. Department of Obstetrics, Gynecology and Reproductive Medicine, Saarland University, 66421 Homburg, Germany

Abstract

Background and Objectives: The uterine smooth muscle tumors of uncertain malignant potential (STUMP) are tumors with pathological characteristics similar to leiomyosarcoma, but that do not satisfy histological criteria for leiomyoma. These are problematic lesions with intermediate morphologic features; thus, diagnosis and treatment are difficult. This narrative review aims to review data in the literature about STUMPs, particularly focusing on management and therapeutic options and strategies for women who desire to preserve fertility. Material and Methods: authors searched for “uterine smooth muscle tumor of uncertain malignant potential” in PubMed and Scopus databases, from 2000 to March 2023. Pertinent articles were obtained in full-text format and screened for additional references. Only articles in English language were included. Studies including full case description of patients with histopathological diagnosis of STUMP in accordance with Stanford criteria were included. Results: The median age was 43 years old. Symptoms are similar to those of leiomyomas, with a mean diameter of 8.0 cm. Total hysterectomy with or without bilateral salpingo-oophorectomy is the standard care for women if fertility desire is satisfied. Myomectomy alone can be considered for young patients. Although these tumors have not a high malignant potential, several studies described recurrence and metastases. Conclusions: STUMPs are complex uterine smooth muscle tumors, with a rare but reasoned clinical–diagnostic management. Considering the high clinical and histological complexity of these tumors, high level of expertise is mandatory.

Publisher

MDPI AG

Subject

General Medicine

Reference50 articles.

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