Uterine Cancer pp 411-416 | Cite as

Smooth Muscle Tumors of Uncertain Malignant Potential of Uterine Origin

  • Neetha Sreedharan
  • K. Chitrathara


Smooth muscle tumors of uncertain malignant potential or otherwise known as the “STUMP” is a rare group of smooth muscle tumors intermediate between leiomyomas and leiomyosarcomas (LMS) [1] . The term “STUMP” was first used by Kempson in 1973 [2]. It was the work of Taylor and Norris which established the importance of mitotic figures in evaluating smooth muscle tumors of the uterus a half century ago [2], but it soon became evident that some uterine smooth muscle neoplasms with relatively low mitotic indices (5–10 mitotic figures [mf] per 10 high-power fields [hpf]) were capable of behaving in a clinically aggressive manner and that not all tumors with a mitotic index greater than 10 mf/10 hpf were clinically malignant. The term smooth muscle tumor of uncertain malignant potential was created for the 5–9 mitotic index group to reflect the uncertainty about the true failure rate in this group [3–7]. WHO defines STUMP as a smooth muscle tumor that cannot be diagnosed reliably as benign or malignant on the basis of generally applied criteria [8].


Mitotic Index Mitotic Figure Uterine Fibroid Smooth Muscle Tumor Heavy Menstrual Bleeding 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Deodhar KK, Goyal P, Rekhi B, et al. Uterine smooth muscle tumors of uncertain malignant potential and atypical leiomyoma: a morphological study of these grey zones with clinical correlation. Indian J Pathol Microbiol. 2011;54:706–11.CrossRefPubMedGoogle Scholar
  2. 2.
    Kempson RL. Sarcomas and related neoplasms. In: Noris HJ, Hertig AT, Abel MR, editors. The uterus. Baltimore: Williams and Wilkins; 1973.Google Scholar
  3. 3.
    Bell SW, Kempson RL, Hendrickeson MR. Problematic uterine smooth muscleneoplasms: a clinicopathological study of 213cases. Am J Surg Pathol. 1994;18:535–58.CrossRefPubMedGoogle Scholar
  4. 4.
    Kempson R, Bari W. Uterine sarcomas: classification diagnosis and prognosis. Hum Pathol. 1970;1:331–49.CrossRefPubMedGoogle Scholar
  5. 5.
    O’Connor D, Norris H. Mitotically active leiomyoma of the uterus. Hum Pathol. 1990;21:223–7.CrossRefPubMedGoogle Scholar
  6. 6.
    Perrone T, Dehner L. Prognostically favorable mitotically active smooth muscle tumors of the uterus. Am J Surg Pathol. 1988;12:1–8. PubMed | ISI | ChemPort.CrossRefPubMedGoogle Scholar
  7. 7.
    Prayson RA, Hart WR. Mitotically active leiomyomas of the uterus. Am J Clin Pathol. 1992;97:14–20.PubMedGoogle Scholar
  8. 8.
    Tavassoli FA, Devilee P, editors. Chapter 4: Tumours of the uterine corpus. In Pathology and genetics of tumours of the breast and female genital organs: World Health Organization classification of tumors. Geneva: WHO press; 2012.Google Scholar
  9. 9.
    Ng JSY, Han A, Chew SH, Low J. A clinicopathologic study of uterine smooth muscle tumours of uncertain malignant potential (STUMP). Ann Acad Med Singapore. 2010;39:625–8.PubMedGoogle Scholar
  10. 10.
    Tanaka YO, Nishida M, Tsunoda H, et al. Smooth muscle tumors of uncertain malignant potential and leiomyosarcomas of the uterus: MR findings. J Magn Reson Imaging. 2004;20(6):998–1007.CrossRefPubMedGoogle Scholar
  11. 11.
    Mayerhofer K, Lozanov P, Bodner K, Bodner-Adler B, Kimberger O, Czerwenka K, et al. Ki-67 expression in patients with uterine leiomyomas, uterine smooth muscle tumors of uncertain malignant potential (STUMP) and uterine leiomyosarcomas (LMS). Acta Obstet Gynecol Scand. 2004;83:1085–8.CrossRefPubMedGoogle Scholar
  12. 12.
    Ip PP, Cheung AN, Clement PB. Uterine smooth muscle tumors of uncertain malignant potential (stump): a clinicopathologic analysis of 16 case. Am J Surg Pathol. 2009;33:992–1005.CrossRefPubMedGoogle Scholar
  13. 13.
    Odunsi K, Pejovic T. Gynecological cancers multidisciplinary approach to diagnosis and treatment of uterine sarcoma. New York: Demos Publishing Company; 2013. p. 83–93.Google Scholar
  14. 14.
    Guntupalli SR, Ramirez PT, Anderson ML, Milam MR, Bodurka DC, Malpica A. Uterine smooth muscle tumor of uncertain malignant potential: a retrospective analysis. Gynecol Oncol. 2009;113(3):324–6.CrossRefPubMedGoogle Scholar
  15. 15.
    Kotsupoulos IC, Barbetakis N, Asteriou C, et al. Uterine smooth muscle tumor of uncertain malignant potential: a rare cause of multiple pulmonary nodules. Indian J Med Paediat Oncol. 2012;33(3):176–8.CrossRefGoogle Scholar
  16. 16.
    Shapiro A, Ferenczy A, Turcotte R, Bruchim I, Gotlieb WH. Uterine smooth-muscle tumor of uncertain malignant potential metastasizing to the humerus as a high-grade leiomyosarcoma. Gynecol Oncol. 2004;94(3):818–20.CrossRefPubMedGoogle Scholar
  17. 17.
    Philip PC, Tse KY, Tam KF. Uterine smooth muscle tumors other than the ordinary leiomyomas and leiomyosarcomas: a review of selected variants with emphasis on recent advances and unusual morphology that may cause concern for malignancy. Adv Anat Pathol. 2010;17(2):91–111.CrossRefGoogle Scholar

Copyright information

© Springer India 2015

Authors and Affiliations

  1. 1.Department of Surgical and Gynaecologic OncologyLakeshore Hospital and Research CentreKochiIndia
  2. 2.Lakeshore Hospital and Research CentreKochiIndia
  3. 3.Department of Surgical and Gynecologic OncologyWelcare HospitaKochiIndia

Personalised recommendations