Smooth muscle tumors of the uterus encompass a large group of neoplasms representing the entire spectrum from benign to malignant. This includes benign uterine myomas, malignant leiomyosarcoma, and STUMPs (smooth muscle tumors of uncertain malignant potential).

Uterine myomas, also known as uterine fibroids or uterine leiomyomas, are the most common benign tumors of the genital organs of women of childbearing age. This disease has a negative impact on reproductive system, with a significant female morbidity and impairment of life quality. According to the literature, 40–60% of all hysterectomies are scheduled for fibroids, as the most common worldwide indication. The first who described uterine myomas was Matthew Baillie in 1793: they consist mainly of smooth muscle cells with different amounts of fibrous tissue, clearly surrounded by a neurofibrovascular network, the pseudocapsule, which enables their enucleation and enhances myometrial healing. Because of the wide spread of this disease, clinical interventions and costs associated with uterine myomas continue to escalate. For this reason, the interest and research in different myoma aspects, including transcription factors and gene targets involved in myoma development and new pharmacological and surgical treatments, have grown exponentially in the last several years.

Given this scenario, in this special issue we want to focus our attention on some aspects of uterine myoma pathophysiology including clinical features, animal models, molecular alterations, imaging characteristics, and therapeutic and surgical approaches. Understanding the many cellular processes that contribute to myoma formation could lead to targeted approaches to prevent and treat this disease. This can also shed light on the biological association between uterine myomas, STUMPs, and leiomyosarcoma. In fact, an additional level of complexity comes from the reliable differentiation between benign leiomyomas and uterine sarcomas. The diagnosis of uterine sarcoma is based upon histological examination, and uterine sarcomas are most commonly diagnosed following myomectomy or hysterectomy for presumed leiomyomas.

With so many questions, we invite investigators to contribute with original research articles as well as review articles that seek to address the contribution on myoma aspects.

Potential topics include but are not limited to the following:

• Myoma and anatomical, biological, and genetic aspects
• Diagnostic and prognostic significance of uncertain myoma biological aspects
• Myoma and imaging
• Myoma and fertility
• Myoma and animal models
• Myoma and surgical treatments
• Myoma and surgical controversies
• EMT signaling networks in the pathogenesis of leiomyosarcoma
• Myoma and pharmacology, including targeting of EMT markers
• Controversies on uterine myoma treatments