Gynecologic oncology reports · 2026
Fertility-sparing surgery for a patient with a pre-operative suspected diagnosis of a Uterine Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP): A case report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Kipp Matthew P, Roecker Zoe A, Mashayekhi Azin, Scalici Jennifer M, Ramirez-Caban Laura C
Аннотация
BACKGROUND: Uterine smooth muscle tumors of uncertain malignant potential (STUMPs) are rare tumors that share features with benign leiomyomas and malignant leiomyosarcomas. The standard treatment is a total hysterectomy for those without intentions of future pregnancy. However, myomectomy has been reported as a potential fertility-sparing option based on retrospective data.
CASE: We report a case of a healthy 34-year-old gravida 0 patient with a history of fibroids and chronic pelvic pain who presented for a fertility evaluation. She was referred to minimally invasive gynecologic surgery for management of a uterine fibroid and underwent a hysteroscopic partial myomectomy. Initial pathology of the biopsy was concerning for STUMP. A follow-up MRI and PET CT showed no evidence of abnormal features or uptake in the lesion or metastasis. The patient strongly desired future fertility. After shared decision making with the patient and consultation with gynecologic oncology, a fertility-sparing surgical approach was taken. She subsequently underwent an abdominal myomectomy without morcellation. Final pathology of the lesion was benign and consistent with symplastic leiomyoma, or leiomyoma with bizarre nuclei (LBN).
CONCLUSION: In patients desiring future fertility and concern for STUMP, myomectomy without morcellation and continued surveillance can be considered as an alternate treatment option.
CASE: We report a case of a healthy 34-year-old gravida 0 patient with a history of fibroids and chronic pelvic pain who presented for a fertility evaluation. She was referred to minimally invasive gynecologic surgery for management of a uterine fibroid and underwent a hysteroscopic partial myomectomy. Initial pathology of the biopsy was concerning for STUMP. A follow-up MRI and PET CT showed no evidence of abnormal features or uptake in the lesion or metastasis. The patient strongly desired future fertility. After shared decision making with the patient and consultation with gynecologic oncology, a fertility-sparing surgical approach was taken. She subsequently underwent an abdominal myomectomy without morcellation. Final pathology of the lesion was benign and consistent with symplastic leiomyoma, or leiomyoma with bizarre nuclei (LBN).
CONCLUSION: In patients desiring future fertility and concern for STUMP, myomectomy without morcellation and continued surveillance can be considered as an alternate treatment option.