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Abstract：
OBJECTIVE: to analyse the clinical-pathological characteristics, treatment, and evolution of uterine smooth muscle tumours with uncertain malignant potential (STUMP) diagnosed in the Salamanca University Hospital with the implementation of the 2014 WHO criteria.
METHODS: a retrospective descriptive study of patients diagnosed with STUMP from January 2015 to March 2023 at the Salamanca University Hospital. Demographic data, preoperative clinical data, treatment, complications, therapeutic results, anatomopathological findings and recurrence time were obtained.
RESULTS: a total of four patients were identified and included in the study. The mean age at diagnosis was 48 years (range 36-67). The surgical indications were abnormal uterine bleeding, compressive symptoms, and the growth of a pelvic mass suspected to be a degenerated myoma from the residual cervix after a subtotal hysterectomy 6 years earlier. In all cases, a laparotomic procedure was performed. A total hysterectomy, sub-total hysterectomy, and the excision of the cervix with STUMP localization were accomplished in two, one, and one patient, respectively. The mean diameter of the tumour pieces was 13 cm (range 8-17 cm), with a mean volume of 816 cc (range 234-1467 cc). The mean follow-up was 47 months, with no recurrence to date.
CONCLUSIONS: STUMPs are a heterogeneous group of tumours with a difficult-to-predict clinical evolution. In most cases, their diagnosis is histological after performing surgery for suspected leiomyoma. Due to their low incidence, there are no specific guidelines for their treatment and control. However, considering their potential risk of recurrence and metastasis, it is advisable to maintain six-monthly controls for 5 years and then annual controls for 5 years more.
METHODS: a retrospective descriptive study of patients diagnosed with STUMP from January 2015 to March 2023 at the Salamanca University Hospital. Demographic data, preoperative clinical data, treatment, complications, therapeutic results, anatomopathological findings and recurrence time were obtained.
RESULTS: a total of four patients were identified and included in the study. The mean age at diagnosis was 48 years (range 36-67). The surgical indications were abnormal uterine bleeding, compressive symptoms, and the growth of a pelvic mass suspected to be a degenerated myoma from the residual cervix after a subtotal hysterectomy 6 years earlier. In all cases, a laparotomic procedure was performed. A total hysterectomy, sub-total hysterectomy, and the excision of the cervix with STUMP localization were accomplished in two, one, and one patient, respectively. The mean diameter of the tumour pieces was 13 cm (range 8-17 cm), with a mean volume of 816 cc (range 234-1467 cc). The mean follow-up was 47 months, with no recurrence to date.
CONCLUSIONS: STUMPs are a heterogeneous group of tumours with a difficult-to-predict clinical evolution. In most cases, their diagnosis is histological after performing surgery for suspected leiomyoma. Due to their low incidence, there are no specific guidelines for their treatment and control. However, considering their potential risk of recurrence and metastasis, it is advisable to maintain six-monthly controls for 5 years and then annual controls for 5 years more.
摘要：
目的：分析临床病理特征，治疗,以及在萨拉曼卡大学医院实施2014年WHO标准后诊断的恶性潜能不确定的子宫平滑肌肿瘤(STUMP)的演变。
方法：对2015年1月至2023年3月在萨拉曼卡大学医院诊断为STUMP的患者进行的回顾性描述性研究。人口统计数据,术前临床资料,治疗,并发症,治疗结果,获得了解剖病理学发现和复发时间。
结果：共有4名患者被确认并纳入研究。诊断时的平均年龄为48岁（范围36-67）。手术指征为异常子宫出血,压迫症状，以及6年前子宫次全切除术后，怀疑是宫颈退化性肌瘤的盆腔肿块的生长。在所有情况下,进行了腹腔镜手术。全子宫切除术,子宫次全切除术,和宫颈切除与STUMP定位在两个完成，一,一个病人,分别。肿瘤块的平均直径为13cm（范围为8-17cm），平均体积为816cc（范围234-1467cc）。平均随访时间为47个月,到目前为止没有复发。
结论：STUMPs是一组异质性肿瘤，具有难以预测的临床演变。在大多数情况下,他们的诊断是在对疑似平滑肌瘤进行手术后的组织学。由于发病率低,他们的治疗和控制没有具体的指南。然而,考虑到其复发和转移的潜在风险，建议保持6个月的控制5年，然后再保持5年的年度控制。
方法：对2015年1月至2023年3月在萨拉曼卡大学医院诊断为STUMP的患者进行的回顾性描述性研究。人口统计数据,术前临床资料,治疗,并发症,治疗结果,获得了解剖病理学发现和复发时间。
结果：共有4名患者被确认并纳入研究。诊断时的平均年龄为48岁（范围36-67）。手术指征为异常子宫出血,压迫症状，以及6年前子宫次全切除术后，怀疑是宫颈退化性肌瘤的盆腔肿块的生长。在所有情况下,进行了腹腔镜手术。全子宫切除术,子宫次全切除术,和宫颈切除与STUMP定位在两个完成，一,一个病人,分别。肿瘤块的平均直径为13cm（范围为8-17cm），平均体积为816cc（范围234-1467cc）。平均随访时间为47个月,到目前为止没有复发。
结论：STUMPs是一组异质性肿瘤，具有难以预测的临床演变。在大多数情况下,他们的诊断是在对疑似平滑肌瘤进行手术后的组织学。由于发病率低,他们的治疗和控制没有具体的指南。然而,考虑到其复发和转移的潜在风险，建议保持6个月的控制5年，然后再保持5年的年度控制。
