Taehan Sanbuinkwa Hakhoe chapchi; Korean journal of obstetrics and gynecology; 대한산부인과학회잡지
Objective : To evaluate clinical-pathological aspects of smooth muscle tumor of uncertain malignant potential (STUMP), comparing those of leiomyosarcomas and to reclassify them according to the revised classification of smooth muscle tumor, and to investigate the clinical value of new classification.Methods : A retrospective review of clinical and pathological characteristics of 11 cases of STUMP and 7 cases of leiomyosarcoma was done at department of obstetrics and gynecology of Ajou university hospital from 1995 to 1999. They were reclassified according to the revised classification by Kempson and Hendrickson in 1994.Results : Patients' age, parity, status of menopause, history of hormonal use were not significantly different. Vaginal bleeding was most common clinical symptom in both groups(STUMP 55%, leiomyosarcoma 63%) and sarcomatous change was suspected in 1 case of STUMPs and 2 cases of leiomyosarcomas with preoperative transvaginal sonographic examination. Two cases of STUMP were treated with myomectomy only and hysterectomy with or without salpingo-oophorectomy was performed in all cases of leiomyosarcomas and 9 cases of 11 STUMPs. No adjuvant therapy was done and none recurred. Ten cases of STUMP and four cases of leiomyosarcoma were reclassified into leiomyoma with increased mitotic index, one STUMP into atypical leiomyoma, and three leiomyosarcomas remained in the same category by revised classification.Conclusion : Such tumors reclassified into leiomyoma with increased mitotic index showed benign clinical course and the results of this study support new classification. However, atypical leiomyoma with low risk recurrence and smooth muscle tumor with low malignant potential still have possibility of malignant clinical course.
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