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Uterine smooth muscle tumours of uncertain malignant potential: single-centre experience and review of the literature.
Prz Menopauzalny. 2020 Mar; 19(1):30-34.PM

Abstract

Introduction

Uterine smooth muscle tumours of uncertain malignant potential (STUMPs) are a rare histologically heterogeneous group of uterine smooth muscle tumours (SMTs). Their malignant potential and clinical differentiation between leiomyoma and leiomyosarcoma remain uncertain prior to surgical removal.

Aim of the study

To investigate the patients and tumour characteristics of patients with STUMPs and to propose algorithms for optimal diagnosis, treatment, and follow-up management.

Material and methods

This was a single-centre retrospective cohort study of all patients who underwent surgery for a preoperative diagnosis of uterine myoma at the University Hospital "Dr. Georgi Stranski", Pleven, Bulgaria during a period of 33 months (from January 2013 until October 2015). Data were obtained from the medical history records. We performed descriptive analysis to characterise the patient population (e.g. demographics, age, contraceptive use, and complaints that led to the diagnosis) and the tumour characteristics. Last data were obtained prior May 2019.

Results

A total of 320 medical records were retrospectively evaluated. The preoperative diagnosis of myoma was confirmed in 279 of the cases (89.4%). In 27 (8.3%) cases the final histological result was completely different. In 14 (2.3%) a histological postoperative diagnosis of STUMP was identified. All 14 STUMP lesions were intramural with a median size of 7.5 cm (range 3.5 to 15 cm). The median age at diagnosis of STUMP was 45.4 years (range 36 to 52 years), and 92.9% (n = 13) of the patients were premenopausal. Ultrasound data of a rapidly growing myoma were a reason for diagnosis in only three patients (25%), whereas 92.9% of the patients (n = 13) presented with heavy menstrual bleeding with or without anaemia. After surgery, none of the patients with STUMP experienced a relapse of the disease within the median follow-up time of 48 months (R = 40-78).

Conclusions

STUMP tumours are rare tumours, predominantly diagnosed in premenopausal women. They define a group of patients with very good long-term prognosis. Therefore, longer follow-up is needed to allow for conclusions on recurrence rate and survival.

Authors+Show Affiliations

Department of Gynaecological Oncology, Medical University of Pleven, Pleven, Bulgaria.Obstetrics and Gynaecology Clinic, Acibadem City Clinic Hospital "Tokuda", Sofia, Bulgaria.Department of Obstetrics and Gynaecology, Medical University of Pleven, Pleven, Bulgaria.Department of Plastic Restorative, Reconstructive, and Aesthetic Surgery, Medical University of Pleven, Pleven, Bulgaria.EXTRO-Lab, Department of Therapeutic Radiology and Oncology, Medical University of Innsbruck, Austria. Tyrolean Cancer Research Institute, Innsbruck, Austria. EORTC Pathobiology Group, Brussels, Belgium.Department of Medical Oncology, Complex Oncological Centre Burgas, Burgas, Bulgaria.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32508554

Citation

Yordanov, Angel D., et al. "Uterine Smooth Muscle Tumours of Uncertain Malignant Potential: Single-centre Experience and Review of the Literature." Przeglad Menopauzalny = Menopause Review, vol. 19, no. 1, 2020, pp. 30-34.
Yordanov AD, Tantchev L, Vasileva P, et al. Uterine smooth muscle tumours of uncertain malignant potential: single-centre experience and review of the literature. Prz Menopauzalny. 2020;19(1):30-34.
Yordanov, A. D., Tantchev, L., Vasileva, P., Strashilov, S., Vasileva-Slaveva, M., & Konsoulova, A. (2020). Uterine smooth muscle tumours of uncertain malignant potential: single-centre experience and review of the literature. Przeglad Menopauzalny = Menopause Review, 19(1), 30-34. https://doi.org/10.5114/pm.2020.95333
Yordanov AD, et al. Uterine Smooth Muscle Tumours of Uncertain Malignant Potential: Single-centre Experience and Review of the Literature. Prz Menopauzalny. 2020;19(1):30-34. PubMed PMID: 32508554.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Uterine smooth muscle tumours of uncertain malignant potential: single-centre experience and review of the literature. AU - Yordanov,Angel D, AU - Tantchev,Latchezar, AU - Vasileva,Polina, AU - Strashilov,Strahil, AU - Vasileva-Slaveva,Mariela, AU - Konsoulova,Assia, Y1 - 2020/04/27/ PY - 2020/01/12/received PY - 2020/01/23/accepted PY - 2020/6/9/entrez PY - 2020/6/9/pubmed PY - 2020/6/9/medline KW - leiomyosarcoma KW - myoma KW - operative treatment KW - smooth muscle tumours with uncertain malignant potential SP - 30 EP - 34 JF - Przeglad menopauzalny = Menopause review JO - Prz Menopauzalny VL - 19 IS - 1 N2 - Introduction: Uterine smooth muscle tumours of uncertain malignant potential (STUMPs) are a rare histologically heterogeneous group of uterine smooth muscle tumours (SMTs). Their malignant potential and clinical differentiation between leiomyoma and leiomyosarcoma remain uncertain prior to surgical removal. Aim of the study: To investigate the patients and tumour characteristics of patients with STUMPs and to propose algorithms for optimal diagnosis, treatment, and follow-up management. Material and methods: This was a single-centre retrospective cohort study of all patients who underwent surgery for a preoperative diagnosis of uterine myoma at the University Hospital "Dr. Georgi Stranski", Pleven, Bulgaria during a period of 33 months (from January 2013 until October 2015). Data were obtained from the medical history records. We performed descriptive analysis to characterise the patient population (e.g. demographics, age, contraceptive use, and complaints that led to the diagnosis) and the tumour characteristics. Last data were obtained prior May 2019. Results: A total of 320 medical records were retrospectively evaluated. The preoperative diagnosis of myoma was confirmed in 279 of the cases (89.4%). In 27 (8.3%) cases the final histological result was completely different. In 14 (2.3%) a histological postoperative diagnosis of STUMP was identified. All 14 STUMP lesions were intramural with a median size of 7.5 cm (range 3.5 to 15 cm). The median age at diagnosis of STUMP was 45.4 years (range 36 to 52 years), and 92.9% (n = 13) of the patients were premenopausal. Ultrasound data of a rapidly growing myoma were a reason for diagnosis in only three patients (25%), whereas 92.9% of the patients (n = 13) presented with heavy menstrual bleeding with or without anaemia. After surgery, none of the patients with STUMP experienced a relapse of the disease within the median follow-up time of 48 months (R = 40-78). Conclusions: STUMP tumours are rare tumours, predominantly diagnosed in premenopausal women. They define a group of patients with very good long-term prognosis. Therefore, longer follow-up is needed to allow for conclusions on recurrence rate and survival. SN - 1643-8876 UR - https://www.unboundmedicine.com/medline/citation/32508554/Uterine_smooth_muscle_tumours_of_uncertain_malignant_potential:_single-centre_experience_and_review_of_the_literature L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/32508554/ DB - PRIME DP - Unbound Medicine ER -
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