PMC8107659_01
Patient MRI findings: (a) sagittal and (b) transverse sections.. Patient identifiable information has been removed from the images. Black arrows indicate areas of interest.
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Magnetic resonance imaging (MRI) images confirmed the finding with extension above the cardinal ligament, projecting in the peritoneal cavity (Figure 1).
Laparoscopic images depicting the stages of STUMP morcellation: (a) the presence of a smooth well-defined 5 cm mass attached to the left side of the cervix, (b) STUMP after opening the broad ligament, (c) solid adhesions of STUMP to adjacent tissues and (d) the bed of STUMP after its removal.
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Considering the young of patient's age, the lesion size and the MRI report, the lesion was removed by power morcellation (Figure 2).
Histological examination of section. Smooth muscle neoplasm identified with epithelioid morphology (a) (H-E x100) and diffuse low to moderate nuclear atypia throughout the tumour (b) and (c), (H-E x400). The mitotic count was low with less than five mitoses or 10 HPF. Areas of necrosis were not observed. Immunohistochemically, the neoplastic cells stained positive for calponin (d) (x40) and were negative for p16 and p53.
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Frozen sections were negative for malignancy (Figure 3). The final histological examination revealed a smooth muscle neoplasm with epithelioid morphology (Figure 3(a)) with low to moderate nuclear atypia (Figure 3(b) and (c)) without necrotic areas or mitotic activity (p53 (-) Caldesmon (+) p16 (-) compatible with STUMP (Figure 3(d)).