Background: The term \"uterine smooth muscle tumor of uncertain malignant potential\" (STUMP) indicates a rare tumor that cannot be classified as a benign leiomyoma or malignant leiomyosarcoma. In this study, we assessed the clinical characteristics, fertility, and oncologic outcomes of patients diagnosed as STUMP in 14 years. In addition, we analyzed the risk factors for recurrence in patients with STUMP. Methods: Medical records of STUMP patients at Peking Union Medical College Hospital (PUMCH) between January 2005 and June 2019 were reviewed and analyzed. Disease-free survival, age of diagnosis, tumor size, surgical procedure, pathology and immunohistochemistry, clinical characteristics, recurrence rate, and reproductive outcomes in the follow-up period were assessed. Univariate and multivariate analyses were performed to determine the prognostic factors. Results: The median age was 42 years old (range: 21-63). Total hysterectomy with or without bilateral salpingo-oophorectomy was performed in 29/67 cases (43.3%), and myomectomy was performed in 38/67 cases (56.7%). Ten patients experienced recurrences, and all but two recurrences occurred within 5 years after the initial surgery. Only two of these recurrences were leiomyosarcoma. There were no deaths in the median follow-up period of 48.4 (range 2.6-170.2) months. There were no remarkable differences in location of tumor between the myomectomy and hysterectomy groups, but the patients in the myomectomy group were younger than those in the hysterectomy group. In univariate and multivariate analysis, mitosis on pathology was the only independent risk factor for recurrence. Expression of Ki-67, p53, and p16 was significantly higher in patients with recurrence. Seven of the 35 patients who attempted to conceive had successful pregnancies. Conclusions: The prognosis of STUMP was favorable and tumors with more than 10 mitoses per 10 high power field should be monitored closely. The surgical procedure was not an independent risk factor of recurrence, and myomectomy may be an acceptable option for patients wishing to preserve fertility.

To evaluate the morphologic features, immunohistochemical profiles, and biological behavior of renal myopericytoma. Six cases of renal myopericytoma are retrospectively retrieved and analyzed by H&E and immunohistochemical staining. Clinically, patient\'s age ranged from 33 to 70 years (median, 56 years). Male to female ratio was 5:1. Five of the six patients were asymptomatic of the urinary tract, the remained one presented with abdomen pain. Grossly, all six tumors were solitary masses with sizes ranging from 1.8 to 7.3 cm of maximum diameter (mean, 4.4 cm). Five tumors were described as well-circumscribed, and 1 case was showed as ill-defined. Histologically, in all cases, numerous thin-walled vessels and a perivascular arrangement of ovoid, spindled or round myoid tumor cells were seen. However, a broad morphologic spectrum ranging from fibroma-like (3 cases), glomangiopericytoma-like (3 cases), angioleiomyoma-like (2 cases), glomoid- like (2 cases), and myofibroma-like (2 cases) components were observed. In addition, 1 neoplasm with immature cellular features and another infiltrating myopericytoma were found. A coexisting papillary adenoma was detected in 1 case. Nuclear atypia was seen in 2 cases. Immunohistochemically, SMA, caldesmon, and MSA were positive in all 6 cases, whereas CD34 and desmin was partial positive in 1 case, respectively. Ki67 index was aproximately 5% in 1 case but less than 2% in the others. All patients are free of disease by follow-up ranging from 14 to 66 months (mean, 38.7 months).