1. Uterine smooth muscle tumors of unknown malignant potential: A challenging question.
- Author
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Gadducci, Angiolo and Zannoni, Gian Franco
- Subjects
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MUSCLE tumors , *SMOOTH muscle tumors , *CANCER , *MYOMETRIUM , *LEIOMYOSARCOMA , *HYSTERO-oophorectomy , *HORMONE therapy - Abstract
Uterine smooth muscle tumors of unknown malignant potential [STUMP]s are neoplasms with pathological features that preclude an equivocal diagnosis of leiomyosarcoma, but that do not fulfill the criteria for leiomyoma or its variants, and raise concerns that the tumors may behave in a malign fashion. Total hysterectomy with or without bilateral salpingo-oophorectomy is the standard treatment if fertility is completed, whereas myomectomy alone can be taken into consideration in young patients who desire to preserve childbearing potential. A careful surveillance every 6 months for 5 years and then yearly is strongly warranted. Patients with STUMP can relapse as either STUMP or leiomyosarcoma in approximately 11–13% of the cases, and their 5-year overall survival ranges from 92 to 100%. The present paper reviews the clinicopathological features of uterine STUMPs with a particular focus on most commonly accepted histopathological criteria for the diagnosis and on biological behaviour of these controversial neoplasms. • Pathological features of STUMPs preclude an equivocal diagnosis of leiomyosarcoma, but do not fulfill criteria for leiomyoma. • Genomic index seems to represent a prognostic tool for predicting the clinical outcome of patients with STUMPs. • Surgery is the standard therapy of STUMPs, whereas there is no role for adjuvant hormone therapy or chemotherapy. • The recurrence rate of STUMPs ranges between 0% and 36%, with a mean value of approximately 13%. • STUMP can relapse as either STUMP or leiomyosarcoma [ABSTRACT FROM AUTHOR]
- Published
- 2019
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