This case study explores a rare instance of a recurrent smooth muscle tumor of uncertain malignant potential (STUMP) in a 42-year-old woman. Vulvovaginal smooth muscle tumors are uncommon, and diagnosing STUMP presents challenges due to its borderline nature between benign and malignant characteristics. STUMP, often found in reproductive organs, shows morphologic features that suggest malignancy without fully meeting the criteria for leiomyosarcoma.
Case Overview
The patient, with a history of two excision surgeries for vulvovaginal masses, presented with a new large vaginal mass after seven years. MRI scans revealed two distinct masses in the vaginal and vulval regions. Surgical intervention was chosen, given the possibility of recurrence and the tumor's uncertain behavior. Both masses were excised successfully without complications.
Histopathological Findings
Microscopic examination indicated spindle cell morphology with mild nuclear atypia and an infiltrative border, common traits of STUMP. Immunohistochemical staining was positive for markers such as Vimentin and Desmin but negative for Cytokeratins, aligning with the STUMP profile. Due to its borderline behavior, long-term monitoring is crucial as recurrence is possible even after successful excision.
Clinical Significance and Recommendations
This case highlights the importance of careful diagnosis and monitoring in STUMP cases. Vulvovaginal STUMP tumors pose diagnostic and therapeutic challenges due to their rarity and potential for recurrence. As per current guidance, a follow-up every six months for the first five years is advised. Continuous monitoring aids in managing any recurrences or transformations into malignant forms, ensuring timely intervention.
🔗 Full Text: https://www.igminresearch.com/articles/html/igmin154
🔗 DOI Link: https://dx.doi.org/10.61927/igmin154
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