Fertility preservation in the setting of a new uterine smooth muscle tumor of uncertain malignant potential (STUMP) diagnosis.

Background: Smooth muscle tumors of uncertain malignant potential (STUMPs) of the uterus present unique challenges to patients and their care teams. Although the diagnosis primarily affects perimenopausal women, in rare cases, it can be seen in younger women desiring fertility preservation. Systematic reviews in available literature support fertility-preserving management options, such as myomectomy, to be equally efficacious in preventing disease progression into sarcoma development compared to hysterectomy. Case presentation: Through careful multidisciplinary collaboration among experts within gynecologic oncology surgery, pathology, radiology, reproductive endocrinology & infertility, and maternal-fetal medicine, we report two cases in which fertility-preserving management was successfully implemented for uterine STUMP. Conclusion: Preservation of fertility in the management of STUMP tumors until childbearing has been completed appears feasible and safe via multidisciplinary care and with close surveillance.