Uterine smooth muscle tumors of uncertain malignant potential (STUMP): A case report

INTRODUCTION

Uterine smooth muscle tumors of uncertain malignant potential (STUMP) are extremely rare, defined as a uterine smooth muscle tumors that cannot be diagnosed as benign or malignant and does not satisfy all the criteria for leiomyosarcoma or leiomyoma.

CASE REPRESENTATION

A 48-year-old woman who presented with a history of heavy menstrual bleeding and pelvic pain. Physical examination revealed an enlarged uterus. Ultrasonography showed lobular and enlarged uterus containing multiples leiomyomas. A subtotal hysterectomy was performed. A Pathological analysis revealed a uterine mass diagnosed as a smooth muscle tumor of uncertain malignant.

DISCUSSION

Uterine STUMPs are rare and are commonly diagnosed by histopathological evaluation following myomectomy or hysterectomy. The most common clinical manifestations of uterine STUMP are the same as leiomyomas. Prognosis for the patient is unclear and there is a risk of recurrence with the tumors. However, considering their potential risk of recurrence and metastasis, it is advisable to maintain six-monthly controls for 5 years and then annual controls for 5 years more.

CONCLUSION

Due to the rarity of uterine STUMP, there are no specific guidelines for their treatment and control. The scientific literature needs to be constantly updated in order to identify masses suspected of malignancy before surgery and improve patient management and follow-up.

A prospective study on contraceptives used by reproductive-aged patients with breast cancer and the assessment of information

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Background: For reproductive-aged breast cancer (BC) patients, contraception is needed during and after treatment. Few data are available concerning the methods used in the real life and the comprehension of patients. The main objective of our study was to describe the contraceptive practice and to identify the need of information for these patients. Methods: We conducted a survey in young BC patients treated at the National Institute of Oncology Rabat–Morocco. We analyzed the contraceptive methods used. Then, we assessed the level of information and counseling about contraception for this population. The SPSS 10.0 software was used for statistical analysis. Results: 72 patients respond to the survey. The mean age was 41.4 ± 6.3 years. 79.2% had localized disease. 97.2 % were under treatment. The sexual activity was maintained in 69.4%. The contraceptive methods used before the diagnosis and after the announcement are summarized in the Table. 52 pts were informed that the hormonal contraception were not recommended. 86.5% had this information from doctors. 67.3% were informed at the moment of announcement of diagnosis, 17.6% at the consultation of surgery, 29.4% before starting chemotherapy, 35.3% during chemotherapy and 17.6% at the end of treatment. After information about the contraceptive methods, 50 % used a masculine condom, 15.7% had a copper IUD, 18.6% used external ejaculation, 14.3% on patient had a tubal ligation and 14.3% didn’t use a contraception method. 66% patients of patients had not asked about contraceptive methods. The reasons: abstinence: 31.3%, the disease is more important than the contraception: 14.6%. Conclusions: Our study found that there is a lack of information concerning contraception for young BC patients. A contraceptive counseling is highly needed to decrease the risk of pregnancy during treatment. [Table: see text]

Metastatic giant basal cell carcinoma: a case report

Basal cell carcinoma is the most common skin cancer, characterised by a slow growing behavior, metastasis are extremely rare, and it occurs in less than 0, 1% of all cases. Giant basal cell carcinoma is a rare form of basal cell carcinoma, more aggressive and defined as a tumor measuring more than 5 cm at its largest diameter. Only 1% of all basal cell carcinoma develops to a giant basal cell carcinoma, resulting of patient's negligence. Giant basal cell carcinoma is associated with higher potential of metastasis and even death, compared to ordinary basal cell carcinoma. We report a case of giant basal cell carcinoma metastaticin lung occurring in a 79 years old male patient, with a fatal evolution after one course of systemic chemotherapy. Giant basal cell carcinoma is a very rare entity, early detection of these tumors could prevent metastasis occurrence and improve the prognosis of this malignancy.

[Leiomyosarcoma of the bladder in a 64 year old patient]

Le leiomyosarcome représente une tumeur rare de la vessie. Sa présentation clinique est non spécifique et dominée par l'hématurie. La résection endoscopique de la vessie avec un examen anathomopathologique permet de poser le diagnostic. La rareté de cette localisation ne permet pas d’établir une stratégie thérapeutique standard, néanmoins la chirurgie reste le traitement le plus utilisé. Nous rapportons le cas d'une patiente âgée de 64 ans, ayant présenté une hématurie. L'examen anatomopathologique d'une résection endoscopique de la vessie a posé le diagnostic d'un leiomyosarcome.