Ultrasound Appearance of Intravascular Uterine Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP): A Case Report

• DOI: 10.3390/diagnostics14131438
• Publication Date: 2024-07-08T08:52:49Z
• Authors: Nina Montik; Camilla Grelloni; Alessandra Filosa; Gaia Goteri; Jacopo Di Giuseppe; Leonardo Natalini; Andrea Ciavattini
• Keywords: Medicine (General); 03 medical and health sciences; IVL; R5-920; 0302 clinical medicine; STUMP; parauterine mass; Case Report; uterine smooth muscle tumor of uncertain malignant potential; pelvic ultrasound; intravascular leiomyomatosis

A 43-year-old patient with a history of uterine fibromatosis was referred to our hospital for menometrorrhagia and pelvic pain. At the pelvic ultrasound, a highly-vascularized myometrial lesion in volumetric increase was described. An elongated, solid, hypoechoic, painless, and highly vascularized left parauterine mass was identified. On histological examination, a uterine smooth muscle tumor of uncertain malignant potential (STUMP) with intravascular invasion of the left uterine vein was diagnosed. The adnexa and peritoneum were free of disease. On a retrospective evaluation of the ultrasound images, we noticed that the intravascular lesion showed sonographic features comparable to the original mass. Moreover, the Color Doppler (CD) analysis revealed an interrupted blood flow within the left uterine vein. In this case, the ultrasound proved to be an accurate diagnostic tool. When inhomogeneous uterine masses are suspected, and a parauterine/paraadnexal mass surrounded by irregular vessels are identified, the sonographer should take into account a risk of intravascular invasion. The patency of uterine and ovarian vessels should be accurately evaluated, to guide a tailored patient surgical approach.