Uterine smooth XXXX of uncertain malignant potential (STUMP): pathology, follow-up and recurrence.

@entity1 @entity146 @entity5 @entity986 @entity876 @entity1822 @entity11090
The term smooth uterine muscle of uncertain malignant potential (STUMPs) indicates a group of uterine smooth @entity11090 (SMTs) that cannot be diagnosed unequivocally as benign or malignant. Diagnosis, surgical management, and follow-up of this @entity5 remain controversial, especially in pre-menopausal @entity1 with fertility desire, due to the @entity146 and prolonged survival rate when compared to @entity1822 . However, recurrence is estimated between 8.7% and 11% and may include delayed-recurrences. We reported five cases of uterine masses treated by surgical procedure diagnosed as STUMP on final pathology. Four @entity1 underwent a total abdominal hysterectomy with or without salpingo-oophorectomy. One @entity1 underwent excision of uterine mass and subsequent total abdominal hysterectomy plus bilateral salpingo-oophorectomy after the diagnosis of STUMP. All @entity1 in our study remained recurrence-free to date (with a follow up period ranging from 6 to 81 months). Based on our experience and in consideration of the lack of consensus regarding the malignant potential, diagnostic criteria, gold-standard treatment and follow-up, we believe that close multidisciplinary management is mandatory in the event of STUMP. We suggest that gynaecologist, dedicated pathologist (with high level of expertize in gynaecological pathology) and oncologist should work as a team in the counselling and management of this @entity5 from detection till completion of follow up. Furthermore, we recommend immunohistochemistry to investigate the overexpression of @entity986 and @entity876 in order to identify the cohort of @entity1 at increased risk of recurrence who may benefit from more aggressive surgical-oncological strategies.
