Abstract
Objective
Uterine smooth muscle tumors of uncertain malignant potential (STUMP) is a heterogeneous
group of tumors with histological and biological diversity that cannot be defined
as a benign leiomyoma or malignant leiomyosarcoma. The study aims to investigate the
diagnostic methods, treatment management and prognosis of STUMP patients in a 13-year
period.
Study design
We retrospectively reviewed the clinicopathologic information of 31 STUMP patients
in Peking University People’s Hospital. Statistical analyses were conducted to compare
the difference of clinical characteristics between the women in myomectomy group and
those in hysterectomy group.
Results
The most common clinical presentation was menstrual disorder. The tumors were mainly
manifested as hypoechoic, non-cystic nodules with low blood flow signal by pelvic
doppler ultrasonography. Most tumors carried Ki-67 index ranging from 10% to 30%.
Immunohistochemical markers such as ER, PR, p16 and Desmin was positively expressed
in tumors. At the first operation, 21 cases underwent myomectomy and 10 cases underwent
hysterectomy. The patients in myomectomy group were younger than those in hysterectomy
group. In the follow-up period, two cases experienced a relapse in the form of STUMP
within 36 months. One case died of cardiovascular accident while the other cases were
alive. Six of 21 women in myomectomy group desired pregnancy and two healthy live
births were recorded.
Conclusion
The diagnosis of STUMP primarily depends on histopathologic features. Fertility-sparing
surgery may be a treatment selection for patients with fertility desire. Patients
with STUMP, especially in the case of myomectomy, should be informed of recurrence
risk and monitored closely.
Keywords
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Article info
Publication history
Published online: August 08, 2021
Accepted:
August 5,
2021
Received in revised form:
July 22,
2021
Received:
May 4,
2021
Identification
Copyright
© 2021 Published by Elsevier B.V.
