Case Report
 
Uterine smooth muscle tumor of uncertain malignant potential: A still debated entity
Asmaa Kouadir1, Abderrahmane El Mazghi2, Khalid Hassouni3
1Resident Doctor, department of Radiotherapy Hassan II University Hospital, Faculty of Medicine and Pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
2Associate Professor, department of Radiotherapy Hassan II University Hospital, Faculty of Medicine and Pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
2Professor and head of the department, department of Radiotherapy Hassan II University Hospital, Faculty of Medicine and Pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco

Article ID: 100024Z08AK2017
doi:10.5348/Z08-2017-24-CR-4

Address correspondence to:
Asmaa Kouadir
Bd urbain, Résidence Gourrama, 2ème étage
n°4, Zohour 2, FES, Maroc
FEZ
Morocco

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How to cite this article:
Kouadir A, El Mazghi A, Hassouni K. Uterine smooth muscle tumor of uncertain malignant potential: A still debated entity. J Case Rep Images Gynecol Obstet 2017;3:13–18.


ABSTRACT
Introduction: Uterine smooth muscle tumors of uncertain malignant potential (STUMPs) are mesenchymal tumors that have been the subject of only a small number of published cases. According to the current World Health Organization classification, uterine STUMP corresponds to an uterine smooth muscle tumor which is not diagnosed unequivocally as benign or malignant. Diagnosis, surgical management and follow-up of these tumors are still controversial.
Case Report: Herein, we describe a case of 44-year-old perimenopausal woman who presented with complaint of isolated progressive pelvic pain. Gynecological examination revealed an enlarged uterus with a bulging mass in the pouch of Douglas. Pelvic ultrasound and pelvic computed tomography scan showed multiple intramural myomas with one large posterior subserosal myoma associated with a suspected ovarian cyst. The patient underwent an exploratory laparotomy with total hysterectomy associated with left adnexectomy and right salpingectomy. On histopathological examination, the diagnosis of uterine STUMP was established. After carrying out a postoperative staging workup which was negative, the patient was kept on a close follow-up schedule. Two years after surgery, the patient is still disease free.
Conclusion: Uterine STUMPs are rare tumors that present a diagnostic challenge for both clinician and pathologist. Immunohistochemical examination seems to be hopeful technique for well diagnosing these tumors as well as identifying those with high risk of recurrence. Due to the possibility of delayed recurrences associated with the prolonged survival rate, long-term surveillance is currently required for women diagnosed with STUMPs.

Keywords: Immunochemistry, Recurrences, Smooth muscle Tumors, Uncertain Malignant Potential, Uterus


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Author Contributions
Asmaa Kouadir – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Abderrahmane El Mazghi – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Khalid Hassouni – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2017 Asmaa Kouadir et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
ABOUT THE AUTHORS

Asmaa Kouadir is Resident Doctor at Department of Radiotherapy, Hassan Ii University Hospital, Faculty of Medicine and Pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco. She Earned undergraduate degree (Mbbs) from Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco and postgraduate degree (Medical Doctor Degree) from Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco. Her research interests include intensity modulated radiotherapy, and head and neck cancers. Email: kouadirasmaa@gmail.com


Abderrahmane El Mazghiis Associate Professor at Department of Radiotherapy, Hassan II University Hospital, Faculty of Medicine and Pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco. He earned undergraduate degree (Mbbs) from Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco and postgraduate degree (Phd) from Department of Radiotherapy, Hassan II University Hospital, Faculty of Medicine and Pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco. He has published 30 research papers in national and international academic journals. His research interests include sarcomas, brachytherapy, and lymphomas.


Khalid Hassouni is Head of Department and Director of Department of Radiotherapy at Hassan II University Hospital, Faculty of Medicine and Pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco. He earned undergraduate degree (Mbbs) from Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco and postgraduate degree (PhD) from Department of Radiotherapy, National Institute of Oncology Sidi Mohamed Ben Abdellah, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco. He has published more than 100 research papers in national and international academic journals. His research interests include intensity modulated radiotherapy, brachytherapy, and head and neck cancers.