Successful pregnancy after laparoscopy-assisted excision of uterine smooth muscle tumor of uncertain malignant potential: A case report and a review of the literature

Abstract

Uterine smooth muscle tumors of uncertain malignant potential (STUMP) are neither benign nor malignant. Herein, we report the case of a successful pregnancy after laparoscopy-assisted excision of uterine cervical STUMP in a 37-year-old woman with secondary infertility. Magnetic resonance imaging showed a tumor, which was suspected to be a uterine cervical leiomyoma. She underwent a laparoscopy-assisted excision, and the final diagnosis was STUMP. The uncertain behavior of STUMP was explained to the couple; since STUMP is an exclusion diagnosis of leiomyoma or leiomyosarcoma, the prognosis was not clear, i.e., the tumor may behave in a benign or malignant fashion. The patient did not undergo further treatment. She conceived naturally 5 months after the operation and delivered a child by cesarean section. Although previous reports have described the recurrence rates of STUMP, they are inconsistent probably due to the challenges encountered to make this diagnosis. At present the diagnosis can only be made postoperatively when histologic features of the tumor, such as necrosis, atypia, or mitotic count, exclude the diagnosis of benign leiomyomas, but do not meet the criteria for leiomyosarcomas. This case highlights that if a patient with infertility is diagnosed with STUMP, she must be counseled about the possibility of recurrence and the need for long-term surveillance.