science

Smooth muscle tumor of uncertain malignant potential

Smooth muscle tumor of uncertain malignant potential is a science topic covered in the lgStudy science library. This page brings together a partial reference excerpt, illustrations, worked examples, real-world applications and a short study plan, so you can understand Smooth muscle tumor of uncertain malignant potential rather than just read about it. In short: Smooth muscle tumor of uncertain malignant potential, abbreviated STUMP, is an uncommon tumor of the uterine smooth muscle that may behave like a benign tumor or a cancerous tumor. This tumor should not be confused with the prostatic stromal tumor of uncertain malignant potential which may be abbreviated the same way (STUMP).

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Reference excerpt

Smooth muscle tumor of uncertain malignant potential, abbreviated STUMP, is an uncommon tumor of the uterine smooth muscle that may behave like a benign tumor or a cancerous tumor. This tumor should not be confused with the prostatic stromal tumor of uncertain malignant potential which may be abbreviated the same way (STUMP). The Bell criteria were developed to help categorize them and differentiate them from their main differential diagnoses, leiomyosarcoma and uterine leiomyoma.

Bell criteria

Atypia none minimal: smooth nuclei, smooth contours, minimal variation in nuclear size, shape, and evenly distributed chromatin moderate: many large, plump, irregular nuclei, 1-2 mitotic figures severe: obvious pleomorphism, enlarged bizarre nuclei with dense chromatin, giant cells, often multinucleated, enlarged, atypical nucleoli

Mitotic figures Evaluation of the mitotic figures in a STUMP requires evaluation of 3 specific criteria

Hairy extensions of chromatin must be present, extending from a central clot-like dense mass of chromosomes. Hairy extensions from an empty center favor a non-mitosis. Count 4 sets of 10 fields in the area of highest mitotic activity and use the highest count No nuclear membrane Rule out lymphocytes, mast cells, stripped nuclei, degenerated cells, and precipitated hematoxylin.

Necrosis Coagulative tumor cell necrosis is common in clinically malignant smooth muscle cell tumors. It consists of an abrupt transition between necrotic cells and preserved cells. Ghost nuclei from necrotic cells are often seen, but inflammatory cells are uncommon. Hyalinizing necrosis is more common in leiomyomas. It consists of a zone of hyalinized collagen between dead cells and preserved cells, commonly eosinophilic. If dead nuclei present, they are uniform and the chromatin is often. Necrosis secondary to ulceration in submucous leiomyomas features acute inflammatory cells and a peripheral reparative process, whereas ghost outlines of nuclei are usually inconspicuous or absent.

Algorithm Bell's criteria do not apply to extrauterine tumors No or mild atypia, no tumor cell necrosis ⇒ leiomyoma. If 5 or more mitotic figures are present in 10 high powered fields but the behavior still appears benign, may append “with significant mitotic activity”. Moderate to severe atypia without tumor cell necrosis atypical leiomyoma if < 10 mitotic figures per high power field or leiomyosarcoma if ≥ 10 mitotic figures per high power field Moderate to severe atypia and tumor cell necrosis ⇒ leiomyosarcoma (mitotic figures don’t matter).

See also Prostatic stromal tumor of uncertain malignant potential

References Guntupalli SR, Ramirez PT, Anderson ML, Milam MR, Bodurka DC, Malpica A (June 2009). "Uterine smooth muscle tumor of uncertain malignant potential: a retrospective analysis". Gynecol. Oncol. 113 (3): 324–6. doi:10.1016/j.ygyno.2009.02.020. PMC 8248445. PMID 19342083. Ng JS, Han A, Chew SH, Low J (August 2010). "A clinicopathologic study of uterine smooth muscle tumours of uncertain malignant potential (STUMP)" (PDF). Ann. Acad. Med. Singap. 39 (8): 625–8. PMID 20838704. Ip PP, Cheung AN, Clement PB (July 2009). "Uterine smooth muscle tumors of uncertain malignant potential (STUMP): a clinicopathologic analysis of 16 cases". Am. J. Surg. Pathol. 33 (7): 992–1005. doi:10.1097/PAS.0b013e3181a02d1c. PMID 19417585. Chen WY, Yang AH, Liu HC (April 1991). "Spindle cell stromal tumors of gastrointestinal tract: a histological and immunohistochemical study". Zhonghua Yi Xue Za Zhi (Taipei). 47 (4): 219–27. PMID 1710946. Pernick, Nat (August 11, 2020). "Smooth muscle tumors of uncertain malignant potential". www.pathologyoutlines.com. Retrieved November 18, 2020.

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Worked examples

Example 1 — a first encounter with Smooth muscle tumor of uncertain malignant potential

Start with the simplest possible case. Write down what Smooth muscle tumor of uncertain malignant potential claims or describes in one sentence, then invent the smallest concrete situation in which that sentence is true. In science, the smallest case is usually a single object, a single equation or a single measurement. Check that every symbol or term in your sentence has a meaning in that case.

Example 2 — changing one variable

Take the situation from Example 1 and change exactly one quantity: double it, halve it, or set it to zero. Predict what should happen to Smooth muscle tumor of uncertain malignant potential before you calculate. Comparing your prediction with the result is the fastest way to find out whether you understand the idea or only the words.

Example 3 — an exam-style question

Typical questions about Smooth muscle tumor of uncertain malignant potential ask you to (a) state it precisely, (b) apply it to given data, and (c) explain a limitation. Practise writing all three answers in under five minutes; the third part is what separates a full-mark answer from an average one.

Applications of Smooth muscle tumor of uncertain malignant potential

In research: Smooth muscle tumor of uncertain malignant potential appears in science research whenever the underlying quantities have to be modelled precisely. Papers usually cite it as a starting assumption and then explore where it breaks down.
In technology and industry: Engineering practice reuses Smooth muscle tumor of uncertain malignant potential in design rules, simulations and safety margins. Knowing the idea lets you read a specification sheet and understand why the numbers look the way they do.
In the classroom: Smooth muscle tumor of uncertain malignant potential is common in secondary-school and first-year university syllabi. It links to neighbouring topics Types of cancer, so understanding it makes those chapters shorter.
In everyday life: Look for Smooth muscle tumor of uncertain malignant potential outside the textbook — in sport, cooking, traffic, electronics or the sky above you. An example you found yourself is remembered far longer than one you were given.

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Frequently asked questions

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