Uterine smooth muscle tumor of uncertain malignant potential (STUMP) is the neoplasm with pathological features that preclude an equivocal diagnosis of leiomyosarcoma, but that do not fulfill the criteria for leiomyoma or its variants, and raise concerns that the tumor may behave in a malignant fashion. The incidence of STUMP is relatively low. The clinical features and imaging manifestations of STUMP are lack of specificity. In most cases, STUMP grow slowly, and the prognosis is worth expecting. However, the actual course of this disease is difficult to predict, and there is a risk of recurrence and malignant transformation. The diagnosis of STUMP depends solely on histopathological examination, but no consensus has been reached on pathological diagnostic criteria. Immunohistochemical molecular typing and genomic analysis may be helpful for the assessment of prognosis factors, but the evidence is limited and further researches are needed. Although there are no guidelines or consensus governing the treatment of STUMP, total hysterectomy with or without bilateral salpingo-oophorectomy is the standard treatment if fertility is completed, whereas myomectomy alone can be taken into consideration in young patients who desire to preserve childbearing potential. Regular follow-up after surgery is important to detect missed diagnosis and tumor recurrence in time.
