scholarly journals A rare case of placental site trophoblastic tumor

2021 ◽  
Vol 10 (9) ◽  
pp. 3594
Author(s):  
Shilpa Bajpai ◽  
Prasad Lele
Keyword(s):  
Vascular Tissue ◽  
Critical Role ◽  
Placental Site Trophoblastic Tumor ◽  
Presenting Symptoms ◽  
Trophoblastic Tumor ◽  
Trophoblastic Cells ◽  
Dilation And Curettage ◽  
Nephritic Syndrome ◽  
Placental Site ◽  
Β Hcg

Placental site trophoblastic tumor (PSTT) is a very rare tumor of young women and unique form of gestational trophoblastic disease (GTD) representing a neoplastic transformation of intermediate trophoblastic cells that play a critical role in implantation. It accounts for 1-2% of all GTNs, incidence of it being 1 in 1,00,000 pregnancies. It displays a wide clinical spectrum from benign lesion within uterus to highly metastatic features with widespread features of metastasis and can be difficult to control even with surgery and chemotherapy. Unlike other forms of GTD, it is characterized by low β-hCG levels because it is a neoplastic proliferation of intermediate trophoblastic cells. PSTT can develop following all kind of pregnancies, whereas approximately 50% of PSTT cases occur after a normal pregnancy and other cases follow abortion, term delivery, ectopic pregnancy and molar pregnancy. Histopathologically, PSTT has proliferation of intermediate trophoblastic cells and absence of villi. It shows less invasion of vascular tissue and using immune histochemistry revealed that PSTT cells expressed HPL more than β-hCG, characterized by increased expression of the HPL in histological section as well as serum. The most common presenting symptoms of PSTT are irregular vaginal bleeding associated with uterine sub involution. Patient can also be presented with amenorrhea, nephritic syndrome, abdominal pain, galactorrhea and hemoptysis. Hence any case of unusual bleeding should be investigated with dilation and curettage and βHCG levels. Although the majority of patients of the non-metastatic PSTT are cured by hysterectomy but in metastatic cases, it requires aggressive treatment with chemotherapy and radiation. Due to its seldom occurrence and uncharacteristic clinical presentation, to reach a correct diagnosis and management is a surgeon’s nightmare and can be very challenging.

scholarly journals A Rare Gestational Trophoblastic Disease: Placental Site Trophoblastic Tumor

2016 ◽  
Author(s):  
Senem Yaman Tunç ◽  
Elif Ağaçayak ◽  
Mehmet Sait İçen ◽  
Serdar Başaranoğlu ◽  
Mehmet Sıddık Evsen ◽  
...  
Keyword(s):  
Uterine Cavity ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Gestational Trophoblastic Disease ◽  
Placental Site Trophoblastic Tumor ◽  
Trophoblastic Tumor ◽  
Trophoblastic Cells ◽  
Placental Site ◽  
Gestational Trophoblastic Diseases ◽  
Abnormal Vaginal Bleeding

<p>Placental site trophoblastic tumor (PSTT) is a highly rare form of gestational trophoblastic diseases that arise from intermediate trophoblastic cells. By presenting this case, we aimed to review the treatment and diagnosis, approach to PSTT.<br />A 31-year-old (G2P1A1L1) patient had abnormal vaginal bleeding. Serum ß-HCG was 5.82 mIU/ml and the transvaginal USG detected a polypoid mass in uterine cavity. Probe curettage was performed. Histopathologic specimens were confirmed as PSTT. No metastasis was detected. A total abdominal hysterectomy was performed.<br />PSTT is a rare tumor. In contrast to other trophoblastic tumors, PSTT produces a small amount of ß-HCG and it is relatively insensitive to chemotherapy. Adjuvant chemotherapy is suggested to follow surgical treatment in the cases with metastasis.</p>

Placental site trophoblastic tumor: report of four cases and review of literature

2007 ◽  
Vol 17 (1) ◽  
pp. 258-262 ◽  
Author(s):  
B. Piura ◽  
A. Rabinovich ◽  
M. Meirovitz ◽  
R. Shaco-Levy
Keyword(s):  
Gestational Trophoblastic Disease ◽  
Primary Treatment ◽  
Placental Site Trophoblastic Tumor ◽  
Review Of Literature ◽  
Trophoblastic Tumor ◽  
Placental Site ◽  
Disease Extension ◽  
Mitotic Figures ◽  
Β Hcg ◽  
The One

Placental site trophoblastic tumor (PSTT) is a rare variant of gestational trophoblastic disease that originates from the implantation site intermediate trophoblast. We report four patients with PSTT and review pertinent literature. Three patients presented with disease confined to the uterus and one patient with disease extension beyond the uterus. Antecedent pregnancy was full-term pregnancy in three patients and termination of a 21-week pregnancy in one patient. Interval from the antecedent pregnancy was <1 year in three patients and 13 years in one patient. Primary treatment was simple hysterectomy in three patients and radical hysterectomy in one patient. Overall, three patients received chemotherapy; one had EP/EMA as adjuvant chemotherapy, one had EMA/CO for rising levels of serum β-hCG and one had BEP then VIP for recurrent disease. The three patients with disease confined to the uterus have remained after treatment alive and with no evidence of disease, whereas the one patient with disease extension beyond the uterus died of disease despite surgery and aggressive chemotherapy. It is concluded that disease extension beyond the uterus is the most important adverse prognostic factor. Other adverse prognostic factors are interval from antecedent pregnancy >2 years, age >40 years, and mitotic count >5 mitotic figures/10 high-power fields. Because of the relative insensitivity to chemotherapy, hysterectomy is the mainstay of treatment. EP/EMA seems to be the most effective first-line chemotherapy available to date for metastatic and relapsing PSTT

Placental site trophoblastic tumor - Ein Fallbericht und Literaturübersicht

Praxis ◽  
2008 ◽  
Vol 97 (7) ◽  
pp. 387-394 ◽  
Author(s):  
J. Kunz, ◽  
F. Bannwart
Keyword(s):  
Sectio Caesarea ◽  
Placental Site Trophoblastic Tumor ◽  
Wird Eine ◽  
Trophoblastic Tumor ◽  
Placental Site ◽  
Welcher Sich ◽  
Β Hcg ◽  
Abdominale Hysterektomie

Vorgestellt wird eine 32-jährige III-Para, bei welcher sich anlässlich der zweiten und der dritten Sectio caesarea eine stille Uterusruptur fand. Nach der dritten Sectio caesarea bestand in der Stillphase während fünf Monaten eine geringgradige uterine Blutung, dann stellte sich unter oraler Kontrazeption eine Amenorrhoe ein. Regelmässige klinische und sonographische Kontrollen zeigten negative Serum-β- HCG-Werte und eine retrovesikale Resistenz, die nach 18 Monaten an Grösse zunahm und symptomatisch wurde. Bei abgeschlossener Familienplanung erfolgte die abdominale Hysterektomie ohne Adnexektomie. Histologisch zeigte sich ein Placental site trophoblastic tumor (PSTT), ein seltener trophoblastärer Tumor mit malignem Potential, dessen Prognose abhängig ist vom primären Tumorstadium, dem Zeitintervall zwischen letzter Schwangerschaft und Erkrankung, dem Alter der Patientin sowie der Mitoserate, und dessen Verlauf mit dem Prognosescore für trophoblastäre Erkrankungen der WHO nicht abgeschätzt werden kann. Therapeutisch empfohlen wird die Hysterektomie. Die Chemosensitivität ist gering und wegen der Seltenheit der Tumoren ist das geeignetste Chemotherapie-Schema nicht bekannt. Bei metastasierenden oder rezidivierenden PSTT hat sich das EP/EMA-Regime als am effektivsten erwiesen.

Placental site trophoblastic tumor in a patient with secondary infertility and radiological findings consistent with a leiomyoma: a case report

2004 ◽  
Vol 14 (4) ◽  
pp. 694-696 ◽  
Author(s):  
K. Sakhel ◽  
A. Khalil ◽  
H. Kaspar ◽  
G. Azar ◽  
A. Mansour ◽  
...  
Keyword(s):  
Residual Tumor ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Filling Defect ◽  
Placental Lactogen ◽  
Placental Site Trophoblastic Tumor ◽  
Secondary Infertility ◽  
Trophoblastic Tumor ◽  
Dilation And Curettage ◽  
Placental Site

Placental site trophoblastic tumor (PSTT) is the rarest form of gestational trophoblastic diseases. We report a 40-year-old woman who presented initially after a year of secondary infertility with prolonged menstrual flow. Her last pregnancy ended in a suction dilation and curettage at 8 weeks' gestation for a missed abortion. A hysterosalpingogram revealed a solid 5 × 4.5 cm filling defect impinging on the endometrial cavity suggestive of a submucosal leiomyoma. A vaginal sonogram confirmed the findings. The patient underwent a laparotomy for excision of the 5-cm friable, necrotic mass that was performed by curetting. Pathologic examination of the specimen revealed sheets of intermediate trophoblastic cells characterized by large polyhedral cells and positive human placental lactogen staining consistent with PSTT. The patient eventually underwent total abdominal hysterectomy 4 weeks later with no evidence of residual tumor on histologic examination.

scholarly journals Placental site trophoblastic tumor unprecedented by conception: a very rare presentation

2021 ◽  
Vol 10 (3) ◽  
pp. 1180
Author(s):  
Sanjay Badesara ◽  
Kiran Jakhar
Keyword(s):  
Elevated Serum ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Gestational Trophoblastic Neoplasia ◽  
Placental Site Trophoblastic Tumor ◽  
Rare Presentation ◽  
Trophoblastic Cells ◽  
Placental Site ◽  
History Of ◽  
Β Hcg

Placental site trophoblastic tumour is the rare variant of gestational trophoblastic neoplasia with incidence rate of approximately 1/100,000 of all pregnancies. Histologically it is characterized by intermediate trophoblastic cells with few syntical elements. The index report depict a 20 years old unmarried female with no history of conception presenting with abnormal uterine bleeding and mildly elevated serum β-HCG level. Multi-modality treatment was given and she had fair outcome. 

scholarly journals Placental site trophoblastic disease

2019 ◽  
Vol 30 (1) ◽  
pp. 144-149 ◽  
Author(s):  
Guido Martin Rey Valzacchi ◽  
Diego Odetto ◽  
Carolina Beatriz Chacon ◽  
Alejandra Wernicke ◽  
Yang Xiang
Keyword(s):  
Treatment Options ◽  
Immunohistochemical Analysis ◽  
Laparoscopic Hysterectomy ◽  
Placental Site Trophoblastic Tumor ◽  
Surveillance Period ◽  
Pelvic Magnetic Resonance Imaging ◽  
Trophoblastic Tumor ◽  
Dilation And Curettage ◽  
Placental Site

A case study of a 38-year-old woman with a diagnosis of placental site trophoblastic tumor is presented. The patient had a 22-month history of amenorrhea since her last pregnancy, and a dilation and curettage procedure was performed after a 3.1×2.4×2.8 cm endometrial echogenic lesion was visualized on a pelvic ultrasound. When the diagnosis of placental site trophoblastic tumor was made by histopathologic and immunohistochemical analysis, complementary examinations including including pelvic magnetic resonance imaging (MRI) and a chest computed tomography (CT) were done. There was no evidence of disease outside the uterus, and a laparoscopic hysterectomy with bilateral salpingectomy was performed. After a surveillance period of 12 months, no disease recurrence was identified. Best imaging studies, treatment options, and proper surveillance for these type of tumors are discussed alongside the case study.

CT and MR Findings of Placental Site Trophoblastic Tumor: A Report of Two Cases

1999 ◽  
Vol 40 (1) ◽  
pp. 137 ◽  
Author(s):  
Kang Hoon Lee ◽  
Kyung Sup Song ◽  
Jae Young Byun ◽  
Seog Nyeon Bae ◽  
Hyeon Sook Kim
Keyword(s):  
Placental Site Trophoblastic Tumor ◽  
Trophoblastic Tumor ◽  
Placental Site

scholarly journals “It’s not lupus”. A placental site trophoblastic tumor presenting as a lupus-like paraneoplastic syndrome. A grand round case

Lupus ◽  
2021 ◽  
pp. 096120332098176
Author(s):  
Sarah J van der Lely ◽  
Jeffrey Boorsma ◽  
Marc Hilhorst ◽  
Jesper Kers ◽  
Joris Roelofs ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Lupus Erythematosus ◽  
Kidney Biopsy ◽  
Gestational Trophoblastic Disease ◽  
Grand Round ◽  
Placental Site Trophoblastic Tumor ◽  
Trophoblastic Tumor ◽  
Anchoring Bias ◽  
Placental Site ◽  
History Of

Introduction: Placental site trophoblastic tumor (PSTT) is a rare subtype of gestational trophoblastic disease. Association of PSTT and nephrotic syndrome is exceedingly rare and has been described in 8 cases thus far. In all cases hysterectomy was performed within months after onset of symptoms, leading to immediate remission of nephrotic syndrome, except for one patient who died of complications of PSTT. Case: We describe the history of a woman in which PSTT was discovered years after onset of nephrotic syndrome. Kidney biopsy revealed lupus-like mesangiocapillary nephritis and over time the patient developed additional symptoms mimicking systemic lupus erythematosus (SLE). Discussion: We provide an overview of the literature on this clinical entity and elaborate on its pathophysiology. In addition, we reflect on the phenomenon of anchoring bias, that led physicians to assume the patient had SLE without questioning this diagnosis in the light of the unexplained finding of increased tumor markers.

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