Retrospective Analysis on Characteristics of Uterine Smooth Muscle Tumors of Uncertain Malignant Potential—13 Years' Experience
Background: Benign leiomyomas (LM) and malignant leiomyosarcomas (LMS) can be distinguished by increased cellularity with mitotic activity. Uterine smooth muscle tumors of uncertain malignant potential (STUMP) are a group of rare tumors in between, for which there is still no standardized classifica...
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IMR Press
2022-10-01
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| Series: | Clinical and Experimental Obstetrics & Gynecology |
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| Online Access: | https://www.imrpress.com/journal/CEOG/49/10/10.31083/j.ceog4910234 |
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| author | Ying-Mei Lin Shiao-Ya Hong Sen-Wen Teng Cheng-Kun Chang Ting-Jung Lai |
| author_facet | Ying-Mei Lin Shiao-Ya Hong Sen-Wen Teng Cheng-Kun Chang Ting-Jung Lai |
| author_sort | Ying-Mei Lin |
| collection | DOAJ |
| description | Background: Benign leiomyomas (LM) and malignant leiomyosarcomas (LMS) can be distinguished by increased cellularity with mitotic activity. Uterine smooth muscle tumors of uncertain malignant potential (STUMP) are a group of rare tumors in between, for which there is still no standardized classification, nor any definitive preoperative imaging or laboratory investigations regarding the possible inclusion of STUMP in the differential diagnosis. Methods: In this study, we retrospectively reviewed 6 cases of STUMP, and assessed their pathogenesis, risk factors, and prognostic features. Results: The mean age of STUMP patients was 40.6 years old. No recurrence has been reported in all six cases after more than 3.6 years of follow-up. The mean tumor size was 9.44 cm (range 6.14–12.21). 4 cases (66.7%) with <5 mitoses, 1 case (16.7%) with 5–9 mitoses, and 1 case (16.7%) with >10 mitoses per 10 high-power fields. Immunohistochemical staining for cyclin dependent kinase nhibitor 2A (p16), tumor protein p53 (p53), and Antigen KI-67 (Ki-67) was 100% positive (2/2, 6/6, and 6/6, respectively). The estrogen receptor (ER) expression rate was 50.0% (3/6), and the progesterone receptor (PR) was 33.3% (1/3). There was no correlation between the expression of these biomarkers and mitotic counts or recurrence. Conclusions: The current immunohistochemical biomarkers are ineffective in determining the probability of malignancy in STUMP patients with desire of further fertility. Detection of gene expression profiles or variants using next-generation molecular techniques may aid in disease prediction, diagnosis, treatment, and prognosis. |
| format | Article |
| id | doaj-art-b3a814e29edd4fca840513671b8a5921 |
| institution | DOAJ |
| issn | 0390-6663 |
| language | English |
| publishDate | 2022-10-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Clinical and Experimental Obstetrics & Gynecology |
| spelling | doaj-art-b3a814e29edd4fca840513671b8a59212025-08-20T03:04:35ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632022-10-01491023410.31083/j.ceog4910234S0390-6663(22)01920-0Retrospective Analysis on Characteristics of Uterine Smooth Muscle Tumors of Uncertain Malignant Potential—13 Years' ExperienceYing-Mei Lin0Shiao-Ya Hong1Sen-Wen Teng2Cheng-Kun Chang3Ting-Jung Lai4Department of Obstetrics and Gynecology, Cardinal Tien Hospital, 23148 New Taipei City, TaiwanMedical Research Center, Cardinal Tien Hospital, 23148 New Taipei City, TaiwanDepartment of Obstetrics and Gynecology, Cardinal Tien Hospital, 23148 New Taipei City, TaiwanDepartment of Obstetrics and Gynecology, Cardinal Tien Hospital, 23148 New Taipei City, TaiwanDepartment of Obstetrics and Gynecology, Cardinal Tien Hospital, 23148 New Taipei City, TaiwanBackground: Benign leiomyomas (LM) and malignant leiomyosarcomas (LMS) can be distinguished by increased cellularity with mitotic activity. Uterine smooth muscle tumors of uncertain malignant potential (STUMP) are a group of rare tumors in between, for which there is still no standardized classification, nor any definitive preoperative imaging or laboratory investigations regarding the possible inclusion of STUMP in the differential diagnosis. Methods: In this study, we retrospectively reviewed 6 cases of STUMP, and assessed their pathogenesis, risk factors, and prognostic features. Results: The mean age of STUMP patients was 40.6 years old. No recurrence has been reported in all six cases after more than 3.6 years of follow-up. The mean tumor size was 9.44 cm (range 6.14–12.21). 4 cases (66.7%) with <5 mitoses, 1 case (16.7%) with 5–9 mitoses, and 1 case (16.7%) with >10 mitoses per 10 high-power fields. Immunohistochemical staining for cyclin dependent kinase nhibitor 2A (p16), tumor protein p53 (p53), and Antigen KI-67 (Ki-67) was 100% positive (2/2, 6/6, and 6/6, respectively). The estrogen receptor (ER) expression rate was 50.0% (3/6), and the progesterone receptor (PR) was 33.3% (1/3). There was no correlation between the expression of these biomarkers and mitotic counts or recurrence. Conclusions: The current immunohistochemical biomarkers are ineffective in determining the probability of malignancy in STUMP patients with desire of further fertility. Detection of gene expression profiles or variants using next-generation molecular techniques may aid in disease prediction, diagnosis, treatment, and prognosis.https://www.imrpress.com/journal/CEOG/49/10/10.31083/j.ceog4910234uterine smooth muscle tumorstumpmitotic activitymalignancy potentialatypical leiomyomaleiomyosarcoma |
| spellingShingle | Ying-Mei Lin Shiao-Ya Hong Sen-Wen Teng Cheng-Kun Chang Ting-Jung Lai Retrospective Analysis on Characteristics of Uterine Smooth Muscle Tumors of Uncertain Malignant Potential—13 Years' Experience Clinical and Experimental Obstetrics & Gynecology uterine smooth muscle tumor stump mitotic activity malignancy potential atypical leiomyoma leiomyosarcoma |
| title | Retrospective Analysis on Characteristics of Uterine Smooth Muscle Tumors of Uncertain Malignant Potential—13 Years' Experience |
| title_full | Retrospective Analysis on Characteristics of Uterine Smooth Muscle Tumors of Uncertain Malignant Potential—13 Years' Experience |
| title_fullStr | Retrospective Analysis on Characteristics of Uterine Smooth Muscle Tumors of Uncertain Malignant Potential—13 Years' Experience |
| title_full_unstemmed | Retrospective Analysis on Characteristics of Uterine Smooth Muscle Tumors of Uncertain Malignant Potential—13 Years' Experience |
| title_short | Retrospective Analysis on Characteristics of Uterine Smooth Muscle Tumors of Uncertain Malignant Potential—13 Years' Experience |
| title_sort | retrospective analysis on characteristics of uterine smooth muscle tumors of uncertain malignant potential 13 years experience |
| topic | uterine smooth muscle tumor stump mitotic activity malignancy potential atypical leiomyoma leiomyosarcoma |
| url | https://www.imrpress.com/journal/CEOG/49/10/10.31083/j.ceog4910234 |
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