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All Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Loli Devianti
Department of Anatomical Pathology, Faculty of Medicine, Universitas Andalas, Padang, Indonesia
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience

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The Large-Mass Phenotype of Uterine Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP): A Clinicopathological Analysis of 37 Cases in Indonesia Using WHO 2021 and Modified Stanford Criteria Yuliza Ariani; Henny Mulyani; Noza Hilbertina; Yenita; Aswiyanti Asri; Tofrizal; Loli Devianti; Hera Novianti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 4 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i4.1565

Abstract

Background: Uterine smooth muscle tumor of uncertain malignant potential (STUMP) presents a diagnostic dilemma, especially in Southeast Asian populations, where delayed presentation often leads to advanced tumor burden. This study aimed to characterize the clinicopathological profile of STUMP in Indonesia using the 2021 WHO Classification and modified Stanford parameters. Methods: A descriptive study analyzed 37 STUMP cases diagnosed between 2023 and 2025 at a tertiary referral center in West Sumatra. A panel of pathologists re-evaluated archival slides for atypia, mitotic activity, necrosis, and growth patterns, establishing inter-observer reliability. Fisher’s Exact Test was employed to correlate tumor size with morphological markers of aggression. Results: The cohort demonstrated a distinct large-mass phenotype, with 54.1% of tumors exceeding 10 cm and a median diameter of 14.5 cm. Pathological review classified 56.8% of cases into WHO Group 4 (atypia with ambiguous mitosis). A statistically significant correlation was identified between tumor size >10 cm and the presence of infiltrative growth margins (81.1%; p=0.034). Conclusion: Indonesian STUMP cases are distinctively characterized by massive size and high rates of infiltrative growth, likely driven by prolonged natural history. The prevalence of ambiguous mitotic figures underscores the utility of the WHO Group 4 category in resource-limited settings. These findings advocate for aggressive surgical management and wider resection margins in large-mass variants to mitigate local recurrence risk.
The Large-Mass Phenotype of Uterine Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP): A Clinicopathological Analysis of 37 Cases in Indonesia Using WHO 2021 and Modified Stanford Criteria Yuliza Ariani; Henny Mulyani; Noza Hilbertina; Yenita; Aswiyanti Asri; Tofrizal; Loli Devianti; Hera Novianti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 4 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i4.1565

Abstract

Background: Uterine smooth muscle tumor of uncertain malignant potential (STUMP) presents a diagnostic dilemma, especially in Southeast Asian populations, where delayed presentation often leads to advanced tumor burden. This study aimed to characterize the clinicopathological profile of STUMP in Indonesia using the 2021 WHO Classification and modified Stanford parameters. Methods: A descriptive study analyzed 37 STUMP cases diagnosed between 2023 and 2025 at a tertiary referral center in West Sumatra. A panel of pathologists re-evaluated archival slides for atypia, mitotic activity, necrosis, and growth patterns, establishing inter-observer reliability. Fisher’s Exact Test was employed to correlate tumor size with morphological markers of aggression. Results: The cohort demonstrated a distinct large-mass phenotype, with 54.1% of tumors exceeding 10 cm and a median diameter of 14.5 cm. Pathological review classified 56.8% of cases into WHO Group 4 (atypia with ambiguous mitosis). A statistically significant correlation was identified between tumor size >10 cm and the presence of infiltrative growth margins (81.1%; p=0.034). Conclusion: Indonesian STUMP cases are distinctively characterized by massive size and high rates of infiltrative growth, likely driven by prolonged natural history. The prevalence of ambiguous mitotic figures underscores the utility of the WHO Group 4 category in resource-limited settings. These findings advocate for aggressive surgical management and wider resection margins in large-mass variants to mitigate local recurrence risk.
The Large-Mass Phenotype of Uterine Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP): A Clinicopathological Analysis of 37 Cases in Indonesia Using WHO 2021 and Modified Stanford Criteria Yuliza Ariani; Henny Mulyani; Noza Hilbertina; Yenita; Aswiyanti Asri; Tofrizal; Loli Devianti; Hera Novianti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 4 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i4.1565

Abstract

Background: Uterine smooth muscle tumor of uncertain malignant potential (STUMP) presents a diagnostic dilemma, especially in Southeast Asian populations, where delayed presentation often leads to advanced tumor burden. This study aimed to characterize the clinicopathological profile of STUMP in Indonesia using the 2021 WHO Classification and modified Stanford parameters. Methods: A descriptive study analyzed 37 STUMP cases diagnosed between 2023 and 2025 at a tertiary referral center in West Sumatra. A panel of pathologists re-evaluated archival slides for atypia, mitotic activity, necrosis, and growth patterns, establishing inter-observer reliability. Fisher’s Exact Test was employed to correlate tumor size with morphological markers of aggression. Results: The cohort demonstrated a distinct large-mass phenotype, with 54.1% of tumors exceeding 10 cm and a median diameter of 14.5 cm. Pathological review classified 56.8% of cases into WHO Group 4 (atypia with ambiguous mitosis). A statistically significant correlation was identified between tumor size >10 cm and the presence of infiltrative growth margins (81.1%; p=0.034). Conclusion: Indonesian STUMP cases are distinctively characterized by massive size and high rates of infiltrative growth, likely driven by prolonged natural history. The prevalence of ambiguous mitotic figures underscores the utility of the WHO Group 4 category in resource-limited settings. These findings advocate for aggressive surgical management and wider resection margins in large-mass variants to mitigate local recurrence risk.
The Large-Mass Phenotype of Uterine Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP): A Clinicopathological Analysis of 37 Cases in Indonesia Using WHO 2021 and Modified Stanford Criteria Yuliza Ariani; Henny Mulyani; Noza Hilbertina; Yenita; Aswiyanti Asri; Tofrizal; Loli Devianti; Hera Novianti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 4 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i4.1565

Abstract

Background: Uterine smooth muscle tumor of uncertain malignant potential (STUMP) presents a diagnostic dilemma, especially in Southeast Asian populations, where delayed presentation often leads to advanced tumor burden. This study aimed to characterize the clinicopathological profile of STUMP in Indonesia using the 2021 WHO Classification and modified Stanford parameters. Methods: A descriptive study analyzed 37 STUMP cases diagnosed between 2023 and 2025 at a tertiary referral center in West Sumatra. A panel of pathologists re-evaluated archival slides for atypia, mitotic activity, necrosis, and growth patterns, establishing inter-observer reliability. Fisher’s Exact Test was employed to correlate tumor size with morphological markers of aggression. Results: The cohort demonstrated a distinct large-mass phenotype, with 54.1% of tumors exceeding 10 cm and a median diameter of 14.5 cm. Pathological review classified 56.8% of cases into WHO Group 4 (atypia with ambiguous mitosis). A statistically significant correlation was identified between tumor size >10 cm and the presence of infiltrative growth margins (81.1%; p=0.034). Conclusion: Indonesian STUMP cases are distinctively characterized by massive size and high rates of infiltrative growth, likely driven by prolonged natural history. The prevalence of ambiguous mitotic figures underscores the utility of the WHO Group 4 category in resource-limited settings. These findings advocate for aggressive surgical management and wider resection margins in large-mass variants to mitigate local recurrence risk.
Clinicopathological Characteristics of Hepatocellular Carcinoma at a Tertiary Hospital: A Retrospective Study Rum Affida Rasfa; Noza Hilbertina; Aswiyanti Asri; Yenita -; Loli Devianti
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 27, No 1 (2026): VOLUME 27, NUMBER 1, April, 2026
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/271202637-44

Abstract

Background: Hepatocellular carcinoma (HCC) is the sixth most common cancer globally and shows significant regional variations in clinicopathological characteristics. Limited data exist on HCC patterns in Indonesia, particularly in West Sumatra. This study aimed to characterize the clinicopathological features of HCC at Dr. M. Djamil Hospital, Padang, from 2021to2024.Methods: A descriptive retrospective study was conducted using medical records and histopathological re-evaluation of 46 HCC cases. Specimens were examined for demographic data, tumor characteristics, histopathological subtypes according to the WHO 2019 classification, differentiation grade, lymphovascular invasion, and background liver pathology.Results: The median age was 56 years, with male predominance (60.9%). Most specimens were resection specimens (60.9%) with tumor size ≥4 cm in 47.8% of cases and single nodules in 52.1%. Clear cell (39.1%) and macrotrabecular massive (37.0%) were the predominant subtypes, contrasting with global data showing NOS predominance. Most tumors were moderately differentiated (63.0%), with lymphovascular invasion present in 65.2% and cirrhotic background in 58.7% of casesConclusion: HCC in West Sumatra demonstrates distinct histopathological patterns, with a predominance of clear cell and macrotrabecular massive subtypes and high rates of lymphovascular invasion. These finding suggest histopathological features associated with aggressive tumor behavior (particularly macrotrabecular massive subtype and lymphovascular invasion), although no clinical outcome or survival analysis was performed.
Co-Authors Aswiyanti Asri Aswiyanti Asri Henny Mulyani Hera Novianti Noza Hilbertina Noza Hilbertina Rum Affida Rasfa Tofrizal Tofrizal Yenita Yenita - Yuliza Ariani