1 Obstetrics and Gynecology Department, Kashan University of Medical Sciences, Kashan, Iran
2 Department of Pathology, Kashan University of Medical Sciences, Kashan, Iran
Introduction: Uterine smooth muscle tumors are the most common human neoplasms. These tumors are clinically classiﬁed into two groups of benign and malignant. However, uterine smooth muscle tumors of uncertain malignant potential (STUMP) are another group between these two groups that cause many diagnostic problems. The present report aimed at introducing a case of STUMP mistaken with ovarian tumor in a female with polio.
Case Presentation: A 43-year-old female with the complaint of abdominal pain and distention, which had started 3 years ago, referred to our center, Kashan, Iran. Abdominal examination showed ﬁrm and irregular distention greater than term pregnancy. Ultrasonography, CT scan, and MRI of the abdomen and the pelvis revealed multiple intramural and subserosal ﬁbroids in the uterus, and a large complex cyst in the abdomen and pelvis that probably originated from the ovary. Laparotomy results showed 2 tumors arising from the anterior surface of the uterus sized 15 × 25 cm, which were extended under the liver, and attached to the omentum and posterior peritoneum of the abdominal cavity wall with moderate ascites. The tumors, which weighted 10 kg along with the uterus, were removed and the patient was discharged after two days in good general health. The pathology report was as follows: uterine adenomyosis and smooth muscle tumors of uncertain malignant potential (STUMP).
Conclusions: STUMP has unpredictable various clinical presentations. Even imaging may mislead the clinicians. Therefore, in patients with pelvic tumors and even with a strong suspicion of ovarian and retroperitoneal tumors, this type of uterine tumors should also be considered, moreover, appropriate treatment should be considered to preserve or not to preserve fertility.
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