Benign in radiology bombshell in cytology

Abstract

Smooth muscle tumor of uncertain malignant potential is a surprise post-operative histopathological finding after myomectomy or hysterectomy. These are aligned between benign and malignant which shares but does not fulfil the complete diagnostic criteria of leiomyosarcoma. Preoperative diagnosis by clinical or radiological examination is uncertain and the diagnosis is only by histopathology. Among women undergoing myomectomy or hysterectomy for a presumed diagnosis of leiomyoma, 0.01% receive a diagnosis of STUMP. Once diagnosed as STUMP, the gold standard treatment option is surgical removal of uterus. As there are no strict accurate protocols for the management of STUMP, the treatment choices should be based on the age of the patient, status and desire to preserve fertility, location of the tumor, metastases, recurrences and pathologic types. Here with we are presenting a case of nulligravida admitted for abnormal uterine bleeding with severe anaemia diagnosed as STUMP on histopathological examination, managed by myomectomy followed by regular follow up for the sake of fertility status. Post operative regular clinical and radiological follow up is mandatory for early pick up of recurrence or metastases.