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Background <p>“Smooth Muscle Tumors of Uncertain Malignant Potential (STUMP)” are borderline tumors lying between the leiomyomas and leiomyosarcomas. These are also known as transitional tumors. “Out of total women undergoing hysterectomy/myomectomy, 0.01% receives the final diagnosis of STUMP on histopathology.” This is a rare tumor with potential of recurrence/metastasis and inconsistent diagnostic criteria and lack of definitive guidelines in case of recurrence.</p> Case series <p>We encountered four patients at our center over a period of 4.5&#xa0;years with varied symptoms and final diagnosis of STUMP on histopathology examination (HPE) stumped us. First patient, underwent Total Abdominal Hysterectomy (TAH) and Bilateral (B/L) salpingectomy for HMB. STUMP on HPE fauxed us. Second case, underwent TAH + B/L salpingectomy for failed medical management. STUMP came as surprise in HPE. Third case patient had TAH with B\L salpingectomy for symptomatic fibroid uterus. Final HPE was STUMP. Last patient final HPE was Leiomyoma with focal infarction but presented 4&#xa0;years after with complaints of abdomen pain. Clinical examination and imaging revealed mass on vault. Needle biopsy from lesion came as Leiomyosarcoma. Review of slide blocks from the primary surgery startled us as the initial specimen was actually STUMP. Patient is on palliative chemotherapy.</p> Conclusion <p>STUMP are rare and heterogeneous uterine tumors and preoperative diagnosis becomes a diagnostic challenge due to its varied and indolent presentation. Diagnosing STUMP using imaging modalities is also not accurate. Regular follow-up with clinical examination and USG/MRI is essential to detect any recurrence.</p>

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“STUMPing” the Gynecologist: Our Experience

  • 期刊论文

  • 发表日期：

    2025年2月7日

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  • Bikram Bhardwaj,
  • Sanjay Singh,
  • Vinod Dalal,
  • M. K. Tangri,
  • Sanjay Sharma,
  • Vipin Kumar Prajapati,
  • Souvik Nandy,
  • Deepti Mishra

摘要

Background

“Smooth Muscle Tumors of Uncertain Malignant Potential (STUMP)” are borderline tumors lying between the leiomyomas and leiomyosarcomas. These are also known as transitional tumors. “Out of total women undergoing hysterectomy/myomectomy, 0.01% receives the final diagnosis of STUMP on histopathology.” This is a rare tumor with potential of recurrence/metastasis and inconsistent diagnostic criteria and lack of definitive guidelines in case of recurrence.

Case series

We encountered four patients at our center over a period of 4.5 years with varied symptoms and final diagnosis of STUMP on histopathology examination (HPE) stumped us. First patient, underwent Total Abdominal Hysterectomy (TAH) and Bilateral (B/L) salpingectomy for HMB. STUMP on HPE fauxed us. Second case, underwent TAH + B/L salpingectomy for failed medical management. STUMP came as surprise in HPE. Third case patient had TAH with B\L salpingectomy for symptomatic fibroid uterus. Final HPE was STUMP. Last patient final HPE was Leiomyoma with focal infarction but presented 4 years after with complaints of abdomen pain. Clinical examination and imaging revealed mass on vault. Needle biopsy from lesion came as Leiomyosarcoma. Review of slide blocks from the primary surgery startled us as the initial specimen was actually STUMP. Patient is on palliative chemotherapy.

Conclusion

STUMP are rare and heterogeneous uterine tumors and preoperative diagnosis becomes a diagnostic challenge due to its varied and indolent presentation. Diagnosing STUMP using imaging modalities is also not accurate. Regular follow-up with clinical examination and USG/MRI is essential to detect any recurrence.