Abstract
Uterine smooth muscle tumors exhibit a wide range of pathological forms and biological behaviors. While leiomyomas are typically benign and frequently encountered, there exist rare variants and malignant counterparts that present notable diagnostic and therapeutic challenges. This case series explores a diverse group of uterine smooth muscle tumors, including leiomyomas with elevated mitotic figures, uterine tumors resembling ovarian sex cord tumors (UTROSCT), smooth muscle tumors of uncertain malignant potential (STUMP), myxoid leiomyosarcoma, and inflammatory leiomyosarcoma. Each case is described with a focus on histopathological features, immunohistochemical profile, clinical presentation, and corresponding management. The series underscores the importance of precise pathological categorization in guiding individualized treatment approaches.