Uterine Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP) Treated with Conservative Surgery: Systematic Review of Reproductive Outcomes

Background: Uterine smooth muscle tumors of uncertain malignant potential (STUMPs) are a rare tumor that represent a diagnostic challenge to both clinicians and pathologists. Hysterectomy is considered the definitive treatment in women who don’t desire to conceive anymore; while myomectomy is sugges...

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Main Authors: Martina Arcieri, Stefano Cianci, Canio Martinelli, Silvana Parisi, Stefano Pergolizzi, Vito Andrea Capozzi, Marco La Verde, Carlo Ronsini, Stefano Restaino, Giuseppe Vizzielli, Vittorio Palmara, Roberta Granese, Alfredo Ercoli
Format: Article
Language:English
Published: IMR Press 2022-12-01
Series:Clinical and Experimental Obstetrics & Gynecology
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Online Access:https://www.imrpress.com/journal/CEOG/49/12/10.31083/j.ceog4912267
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author Martina Arcieri
Stefano Cianci
Canio Martinelli
Silvana Parisi
Stefano Pergolizzi
Vito Andrea Capozzi
Marco La Verde
Carlo Ronsini
Stefano Restaino
Giuseppe Vizzielli
Vittorio Palmara
Roberta Granese
Alfredo Ercoli
author_facet Martina Arcieri
Stefano Cianci
Canio Martinelli
Silvana Parisi
Stefano Pergolizzi
Vito Andrea Capozzi
Marco La Verde
Carlo Ronsini
Stefano Restaino
Giuseppe Vizzielli
Vittorio Palmara
Roberta Granese
Alfredo Ercoli
author_sort Martina Arcieri
collection DOAJ
description Background: Uterine smooth muscle tumors of uncertain malignant potential (STUMPs) are a rare tumor that represent a diagnostic challenge to both clinicians and pathologists. Hysterectomy is considered the definitive treatment in women who don’t desire to conceive anymore; while myomectomy is suggested in young women who desire to preserve their fertility. The aim of this review is to evaluate the reproductive outcomes in patients submitted to fertility sparing treatment and with a diagnosis of STUMP at the definitive pathological evaluation. Methods: We searched among electronic databases from inception of them through January 2022. The research was conducted using meshes created by the combination of relevant heading term, key words, and word variants for: “uterine smooth muscle tumor of uncertain malignant potential”, “fertility”, “pregnancy”. Results: Seven retrospective studies including 80 women desirous of conceiving after a diagnosis of STUMP were included in this systematic review. Among these, 33 (41.25%) women got pregnant at least once and we recorded a total number of pregnancies of thirty-nine. Almost all deliveries were performed by caesarean section. Two (6.1%) relapses were diagnosed. Patients were submitted to hysterectomy and STUMP was confirmed as the final pathological diagnosis. The median follow-up in patients who delivered live babies was 61 months after surgery. At the last follow-up, all patients were alive without evidence of disease. Conclusions: This review shows that pregnacy seems to be possible and safe after the diagnosis of STUMP. These women should undergo rigorous follow-up and consider hysterectomy after completion of their reproductive plan. This review could be a useful tool for the counseling and the management of women with STUMP who desire to keep their fertility.
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spelling doaj-art-c9ec8d88d7f747dda33adc524fad85c52025-08-20T03:49:16ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632022-12-01491226710.31083/j.ceog4912267S0390-6663(22)01922-4Uterine Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP) Treated with Conservative Surgery: Systematic Review of Reproductive OutcomesMartina Arcieri0Stefano Cianci1Canio Martinelli2Silvana Parisi3Stefano Pergolizzi4Vito Andrea Capozzi5Marco La Verde6Carlo Ronsini7Stefano Restaino8Giuseppe Vizzielli9Vittorio Palmara10Roberta Granese11Alfredo Ercoli12Department of Biomedical, Dental, Morphological and Functional Imaging Science, University of Messina, 98122 Messina, ItalyDepartment of Human Pathology in Adult and Childhood “G. Barresi'', University of Messina, 98122 Messina, ItalyDepartment of Human Pathology in Adult and Childhood “G. Barresi'', University of Messina, 98122 Messina, ItalyDepartment of Biomedical, Dental, Morphological and Functional Imaging Science, University of Messina, 98122 Messina, ItalyDepartment of Biomedical, Dental, Morphological and Functional Imaging Science, University of Messina, 98122 Messina, ItalyDepartment of Medicine and Surgery, University Hospital of Parma, 43125 Parma, ItalyObstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli'', 80128 Naples, ItalyObstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli'', 80128 Naples, ItalyDepartment of Medicinal Area (DAME) Clinic of Obstetrics and Gynecology, Santa Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, ItalyDepartment of Medicinal Area (DAME) Clinic of Obstetrics and Gynecology, Santa Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, ItalyDepartment of Human Pathology in Adult and Childhood “G. Barresi'', University of Messina, 98122 Messina, ItalyDepartment of Biomedical, Dental, Morphological and Functional Imaging Science, University of Messina, 98122 Messina, ItalyDepartment of Human Pathology in Adult and Childhood “G. Barresi'', University of Messina, 98122 Messina, ItalyBackground: Uterine smooth muscle tumors of uncertain malignant potential (STUMPs) are a rare tumor that represent a diagnostic challenge to both clinicians and pathologists. Hysterectomy is considered the definitive treatment in women who don’t desire to conceive anymore; while myomectomy is suggested in young women who desire to preserve their fertility. The aim of this review is to evaluate the reproductive outcomes in patients submitted to fertility sparing treatment and with a diagnosis of STUMP at the definitive pathological evaluation. Methods: We searched among electronic databases from inception of them through January 2022. The research was conducted using meshes created by the combination of relevant heading term, key words, and word variants for: “uterine smooth muscle tumor of uncertain malignant potential”, “fertility”, “pregnancy”. Results: Seven retrospective studies including 80 women desirous of conceiving after a diagnosis of STUMP were included in this systematic review. Among these, 33 (41.25%) women got pregnant at least once and we recorded a total number of pregnancies of thirty-nine. Almost all deliveries were performed by caesarean section. Two (6.1%) relapses were diagnosed. Patients were submitted to hysterectomy and STUMP was confirmed as the final pathological diagnosis. The median follow-up in patients who delivered live babies was 61 months after surgery. At the last follow-up, all patients were alive without evidence of disease. Conclusions: This review shows that pregnacy seems to be possible and safe after the diagnosis of STUMP. These women should undergo rigorous follow-up and consider hysterectomy after completion of their reproductive plan. This review could be a useful tool for the counseling and the management of women with STUMP who desire to keep their fertility.https://www.imrpress.com/journal/CEOG/49/12/10.31083/j.ceog4912267uterine smooth muscle tumor of uncertain malignant potentialfertility sparing surgerymyomectomyobstetric outcomesrecurrence
spellingShingle Martina Arcieri
Stefano Cianci
Canio Martinelli
Silvana Parisi
Stefano Pergolizzi
Vito Andrea Capozzi
Marco La Verde
Carlo Ronsini
Stefano Restaino
Giuseppe Vizzielli
Vittorio Palmara
Roberta Granese
Alfredo Ercoli
Uterine Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP) Treated with Conservative Surgery: Systematic Review of Reproductive Outcomes
Clinical and Experimental Obstetrics & Gynecology
uterine smooth muscle tumor of uncertain malignant potential
fertility sparing surgery
myomectomy
obstetric outcomes
recurrence
title Uterine Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP) Treated with Conservative Surgery: Systematic Review of Reproductive Outcomes
title_full Uterine Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP) Treated with Conservative Surgery: Systematic Review of Reproductive Outcomes
title_fullStr Uterine Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP) Treated with Conservative Surgery: Systematic Review of Reproductive Outcomes
title_full_unstemmed Uterine Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP) Treated with Conservative Surgery: Systematic Review of Reproductive Outcomes
title_short Uterine Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP) Treated with Conservative Surgery: Systematic Review of Reproductive Outcomes
title_sort uterine smooth muscle tumor of uncertain malignant potential stump treated with conservative surgery systematic review of reproductive outcomes
topic uterine smooth muscle tumor of uncertain malignant potential
fertility sparing surgery
myomectomy
obstetric outcomes
recurrence
url https://www.imrpress.com/journal/CEOG/49/12/10.31083/j.ceog4912267
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