IMR Press / EJGO / Volume 41 / Issue 4 / DOI: 10.31083/j.ejgo.2020.04.5168
Open Access Case Report
A case of recurrent smooth muscle tumor of uncertain malignant potential with abdominal dissemination after morcellation
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1 Cancer Institute Hospital, Koto, Tokyo, Japan
Eur. J. Gynaecol. Oncol. 2020, 41(4), 648–650; https://doi.org/10.31083/j.ejgo.2020.04.5168
Submitted: 4 February 2019 | Accepted: 29 April 2019 | Published: 15 August 2020
Abstract

Objective: Smooth muscle tumor of uncertain malignant potential (STUMP) shares some characteristics with sarcoma but does not meet the full diagnostic criteria. Morcellation is a technique used to extract surgical specimens through a small incision, thereby spreading unsuspected malignant cells. We report a case of STUMP that recurred postoperatively in the abdominal cavity. Case Report: Surgery was performed on a patient diagnosed with uterine leiomyoma, with the tumor morcellated transvaginally. Twelve months later, several abdominal tumors appeared. Pathological specimens were reevaluated, and STUMP was diagnosed. Many tumors in the abdominal cavity of the patient were removed surgically. The postoperative pathologic diagnosis was leiomyosarcoma. Conclusion: This case of unsuspected STUMP recurrence after transvaginal scalpel morcellation illustrates the risk of spillage of malignant cells. Surgeons and surgical pathologists must stay alert to the possibility of occult malignancy, and morcellated tissues should be carefully examined.

Keywords
Leiomyoma
STUMP
Transvaginal scalpel morcellation
Laparoscopy
Total hysterectomy
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