IMR Press / EJGO / Volume 41 / Issue 6 / DOI: 10.31083/j.ejgo.2020.06.2178
Open Access Review
Successful pregnancy after laparoscopy-assisted excision of uterine smooth muscle tumor of uncertain malignant potential: A case report and a review of the literature
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1 Department of Obstetrics and Gynecology, Fukuchiyama City Hospital, 231 Atsunakacho, Fukuchiyama City, Kyoto 620-8505, Japan
2 Department of Obstetrics and Gynecology, Ayabe City Hospital, 20-1 Otsuka Aono-cho, Ayabe City, Kyoto 623-0011, Japan
3 Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
4 Department of Obstetrics and Gynecology, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Hon-machi, Higashiyama-ku, Kyoto 605-0981, Japan
Eur. J. Gynaecol. Oncol. 2020, 41(6), 863–867;
Submitted: 27 June 2020 | Accepted: 6 August 2020 | Published: 15 December 2020

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.

Laparoscopic excision
Figure 1.
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