Vaginal wall smooth muscle tumors: a systematic review of literature and a case report of vaginal STUMP

Background: Despite Smooth Muscle Tumors (SMTs) being the most common mesenchymal neoplasms of the vagina and vulva, they are rare entities. Among these, to date, only three cases of vaginal SMT of Uncertain Malignant Potential have been reported in the literature. Methods: According to the PRISMA statement, research was conducted on PubMed, Scopus, ScienceDirect and Cochrane Library from 2000 to January 2024 for vaginal leiomyomas and from inception to January 2024 for leiomyosarcoma and smooth muscle tumors of uncertain malignant potential (STUMP). All women with histological diagnoses of vaginal SMTs were included in the analysis. Women with a diagnosis of metastasis of SMTs at the vagina arising from other districts and para-urethral leiomyomas were excluded. Results: Of the 888 articles eligible for title screening, 104 met the inclusion criteria and were included. A total of 163 women were included, 78 were affected by vaginal leiomyoma, 82 by vaginal leiomyosarcoma, and 3 by vaginal STUMP. Conclusions: Vaginal STUMP is a rare entity, and no data is retrievable for statistical analysis. Pathologists experts in the gynaecological field, specific immunohistochemistry panels, and wide excision with free resection of margins are strongly recommended to properly recognize and radically remove the neoplasm and reduce the local recurrence threat. The PROSPERO Registration: CRD42023393514.

Vaginal smooth muscle tumors; Vaginal smooth muscle tumor of uncertain potential; Vaginal wide excision

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