Insights into Management of Smooth Muscle Tumours with Uncertain Malignant Potential: A Case Series

Smooth Muscle Tumours with Uncertain Malignant Potential (STUMPs) represent a rare and diagnostically challenging category within uterine neoplasms. These tumours exhibit biological features similar to both benign leiomyomas and malignant leiomyosarcomas, complicating diagnosis and management. STUMPs are characterised by their potential for unpredictable clinical behaviour, including local recurrence and, in rare cases, metastasis, necessitating careful postoperative monitoring. Classifying uterine mesenchymal tumours is difficult due to significant overlap with terms such as atypical leiomyoma, atypical leiomyoma with low risk of recurrence, and atypical leiomyoma with low malignant potential. Despite their infrequent occurrence, STUMPs have garnered increasing attention due to their ambiguous nature and the clinical implications they pose. Diagnostic criteria and management strategies for STUMPs remain areas of active research and debate within gynaecological pathology and oncology. The present case series was aimed to contribute to the existing body of literature by presenting three cases of female patients (aged 38-year-old, 34-yearold and 47-year-old) of large uterine leiomyomas that were later diagnosed as STUMPs postoperatively following hysterectomy. Each case underscores the complexities involved in diagnosing and managing these tumours, emphasising the importance of multidisciplinary collaboration and long-term follow-up in optimising patient outcomes.