Incognito Giosuè G, D'Urso Gisella, Incognito Dalila, Lello Chiara, Miceli Alessia, Palumbo Marco
Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy -
Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy.
Minerva Obstet Gynecol. 2022 Oct;74(5):466-470. doi: 10.23736/S2724-606X.22.05126-0. Epub 2022 Aug 1.
Uterine smooth muscle tumors of uncertain malignant potential (STUMP) represent a group of rare uterine smooth muscle tumors not diagnosed unequivocally as benign or malignant. To data, diagnostic criteria, malignant potential, surgical management, and follow-up of these neoplasms remain controversial. Considering that STUMP and leiomyoma are not significantly different in terms of clinical presentation and preoperative sonographic characteristics, it might be difficult to distinguish between the two affections prior to pathological confirmation at surgery. All cases should be managed by multidisciplinary tumor teams and patients' follow-up should comprise consultation with a gynecologic oncologist and a close surveillance because of the possibility of recurrence or metastasis. We present the case of a 32-year-old nulliparous woman admitted to our gynecology clinic. She was asymptomatic and only complained an increase in abdominal volume started during the past 6 months. A transabdominal and transvaginal pelvic ultrasound revealed a large heterogeneous tumor mass measuring 190×163 mm, color score 2, expanded in the left iliac fossa, suspected for benign uterine myoma. Subsequent magnetic resonance imaging confirmed a large pelvic-abdominal tumor located near the left posterior-lateral uterine wall with areas of necrosis, suggestive of subserosal leiomyoma with cystic degeneration. The patient underwent a median longitudinal laparotomy for excision of the pelvic mass. The patient was normally discharged five days after surgery in good health conditions. The final histological examination was compatible with STUMP. At present, the patient has had no relapses or metastases and she is undergoing follow-up.
子宫平滑肌肿瘤，恶性潜能未定（STUMP）是一组罕见的子宫平滑肌肿瘤，无法明确诊断为良性或恶性。迄今为止，这些肿瘤的诊断标准、恶性潜能、手术管理及随访仍存在争议。鉴于STUMP与平滑肌瘤在临床表现和术前超声特征方面无显著差异，在手术病理确诊之前，可能难以区分这两种疾病。所有病例均应由多学科肿瘤团队管理，由于存在复发或转移的可能性，患者随访应包括咨询妇科肿瘤学家并进行密切监测。我们报告一例32岁未育女性入住我院妇科门诊的病例。她无症状，仅主诉在过去6个月中腹部容积增大。经腹及经阴道盆腔超声检查发现一个大小为190×163 mm的巨大异质性肿瘤团块，血流评分2分，位于左髂窝，怀疑为子宫良性肌瘤。随后的磁共振成像证实盆腔-腹部有一个巨大肿瘤，位于子宫后壁左后外侧附近，伴有坏死区域，提示浆膜下平滑肌瘤伴囊性变。患者接受了正中纵切口剖腹手术以切除盆腔肿块。患者术后5天正常出院，身体状况良好。最终组织学检查结果符合STUMP。目前，该患者无复发或转移，正在接受随访。
