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[恶性潜能未定的平滑肌肿瘤(STUMP)——病例的临床病理形态学分析及文献复习]

[Smooth muscle tumor of uncertain malignant potential (STUMP)--clinico-pathomorphological analysis of the cases and literature review].

作者信息

Dańska-Bidzińska Anna, Bakuła-Zalewska Elwira, Nasierowska-Guttmejer Anna, Kowalewska Magdalena, Barnaś Edyta, Sobiczewski Piotr, Bidziński Mariusz

机构信息

II Klinika Połoznictwa i Ginekologii WUM, Warszawa, Polska.

出版信息

Ginekol Pol. 2012 Jun;83(6):412-6.

Abstract

OBJECTIVES

This retrospective study was designed to evaluate the clinical and pathological features and outcomes of patients diagnosed with uterine smooth muscle tumor of uncertain malignant potential (STUMP).

MATERIAL AND METHODS

Ten patients diagnosed with uterine STUMP and seen between 2008 and 2011 at the Memorial Cancer Center--Institute of Oncology in Warsaw were identified using the institution databases. Variables of interest included histopathological details, age at diagnosis, types of treatment and recurrence rate.

RESULTS

The mean age at diagnosis was 41 years (range 25-56 years). The mean follow-up time was 16 months (range 4-29 months). Diameter of the tumors ranged from 3 to 29 cm. Uterine bleeding was the second most frequent symptom observed in this cohort In three cases conservative procedure was performed, whereas in other patients hysterectomy was performed. No recurrence was observed during the follow-up period. In all tumors mitoses were less than 10 per 10/hpf, atypia of middle or severe type, and in 3 cases necrosis was observed. In half of the tumors expression of TP53 was found, and value of MIB 1 was estimated at 2-35%.

CONCLUSIONS

STUMP should be diagnosed by experienced pathologists due to the fact that they are often misdiagnosed as leiomyosarcomas. Clinical behavior of these tumors allows to consider a conservative management in patients wishing to preserve fertility

摘要

目的

本回顾性研究旨在评估诊断为具有不确定恶性潜能的子宫平滑肌瘤(STUMP)患者的临床和病理特征及预后。

材料与方法

利用华沙纪念癌症中心 - 肿瘤研究所的机构数据库,确定了2008年至2011年间诊断为子宫STUMP并在该中心就诊的10例患者。感兴趣的变量包括组织病理学细节、诊断时的年龄、治疗类型和复发率。

结果

诊断时的平均年龄为41岁(范围25 - 56岁)。平均随访时间为16个月(范围4 - 29个月)。肿瘤直径为3至29厘米。子宫出血是该队列中第二常见的症状。3例患者进行了保守手术,而其他患者进行了子宫切除术。随访期间未观察到复发。所有肿瘤的有丝分裂均少于每10个高倍视野10个,有中度或重度异型性,3例观察到坏死。一半的肿瘤发现TP53表达,MIB 1值估计为2 - 35%。

结论

由于STUMP常被误诊为平滑肌肉瘤,应由经验丰富的病理学家进行诊断。这些肿瘤的临床行为允许对希望保留生育能力的患者考虑保守治疗。

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