STUMP- A Challenging Differential Diagnosis and Therapeutic Dilemma

Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP) refers to a diverse group of uterine neoplasms that do not fully meet the histologic criteria for classification as either benign or malignant tumors. Typically, when a uterine leiomyoma cannot be definitively classified as a standard or variant leiomyoma, adenomyoma, or leiomyosarcoma, it is categorized as a uterine smooth muscle tumor of uncertain malignant potential (STUMP). In our case 20 year nulligravida presented to gynae OPD with heavy menstruation with per abdomen mass of 30 weeks size. Ultrasound showed multiple uterine mass and patient was taken up for myomectomy.Histopathological report showed features suggestive of leiomyosarcoma and second opinion was taken which was suggestive of STUMP. In this case report, we summarize the current state of knowledge about uterine STUMP, with a particular focus on fertility sparing surgeries. The very purpose of reporting this case is to emphasize that STUMP mimicking leiomyosarcoma can affect a very young age girl. With premenopausal age, decision for hysterectomy is easy whereas in a young girl going ahead with hysterectomy is a crucial decision.No doubt it is a multidisciplinary approach with complete patient involvement who needs to be on regular close follow up.