Risk stratification of uterine smooth muscle tumors: The role of morphology, immunohistochemistry, and molecular testing Review


Authors: Momeni-Boroujeni, A.; Nucci, M. R.; Chapel, D. B.
Review Title: Risk stratification of uterine smooth muscle tumors: The role of morphology, immunohistochemistry, and molecular testing
Abstract: Uterine smooth muscle neoplasms are a biologically and clinically heterogeneous group of tumors. Morphology is the cornerstone of pathologic diagnosis of these tumors, and most are readily classified as benign or malignant on the basis of routine histologic examination. However, rare subsets-including intravenous leiomyomatosis, benign metastasizing leiomyoma, and disseminated peritoneal leiomyomatosis-have a capacity for extrauterine spread despite benign cytomorphology. A further subset of uterine smooth muscle neoplasms, termed "smooth muscle tumor of uncertain malignant potential (STUMP)," are not readily classified as benign or malignant and carry an intermediate prognosis. STUMP is a protean category, whose precise definition is subject to disagreement among experts. The risk profiles of different STUMP morphotypes remain largely unresolved. Finally, multiple morphology-based systems for risk stratification of uterine leiomyosarcoma have been proposed, though none is widely adopted. Immunohistochemical and molecular prognostic markers for both STUMP and leiomyosarcoma remain in the early phases of adoption in routine diagnostic practice.
Keywords: leiomyomatosis; leiomyosarcoma; uterine neoplasms; uterus; genomic hybridization; smooth muscle tumor; case series; clinicopathological analysis; intravenous leiomyomatosis; diagnostic-criteria; benign metastasizing leiomyoma; disseminated peritoneal leiomyomatosis; malignant potential stump; bizarre nuclei
Journal Title: Advances in Anatomic Pathology
Volume: 32
Issue: 1
ISSN: 1072-4109
Publisher: Lippincott Williams & Wilkins  
Date Published: 2025-01-01
Start Page: 44
End Page: 56
Language: English
ACCESSION: WOS:001381967200003
DOI: 10.1097/pap.0000000000000478
PROVIDER: wos
PUBMED: 39711162
Notes: Article -- Source: Wos
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors