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Imaging and Clinical Data of Placental Site Trophoblastic Tumor: A Case Report

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ABSTRACT

Placental site trophoblastic tumor (PSTT) is a very rare variant of gestational trophoblastic tumor. It can occur after normal termination of pregnancy or spontaneous abortion and ectopic or molar pregnancy. There is a wide range of clinical manifestations from a benign condition to an aggressive disease with fatal outcome. One of the most important characteristics of PSTT, unlike other forms of gestational trophoblastic diseases (GTD) is the presence of low beta-subunit of human chorionic gonadotropin (β-hCG) levels because it is a neoplastic proliferation of intermediate trophoblastic cells. However, human placental lactogen (hPL) is increased on histologic section and in the serum of patients too. We present a case of PSTT and discuss the differential diagnosis in order to further familiarize physicians with the diagnosis and treatment of this disease. It has a varied clinical spectrum and usually presents with irregular vaginal bleeding or amenorrhea. Diagnosis is confirmed by dilatation and curettage (D and C) and hysterectomy. Because chemotherapy is not effective, surgery is the cornerstone of treatment. This case is presented because it is a rare neoplasm with different treatments and it should be differentiated from molar pregnancy.

No MeSH data available.


Schematic features of the blastocyst and trophoblast. The blastocyst comprises an inner cell mass that subsequently forms the embryo and the outer layer called trophoblast that provides nutrients to the embryo and develops into a large part of the placenta.
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fig32507: Schematic features of the blastocyst and trophoblast. The blastocyst comprises an inner cell mass that subsequently forms the embryo and the outer layer called trophoblast that provides nutrients to the embryo and develops into a large part of the placenta.

Mentions: Placental site trophoblastic tumor (PSTT) is a slow growing malignant intermediate trophoblastic tumor and a rare form of gestational trophoblastic disease (GTD) (1). PSTT is the least common form of gestational trophoblastic neoplasia composed of predominantly intermediate trophoblasts (Figure 1). Since 1981, about 150 cases have been reported in literature. The incidence of PSTT is about 1/100000 pregnancies and it constitutes about 1 - 2% of all GTDs (1). For the first time, Larsen et al. proposed the term of PSTT in 1991. It was considered as an exaggerated form of reaction of the placental bed (2). PSTT can occur several months, or even years, after the pregnancy including molar and ectopic, miscarriage and abortion, or a full term normal pregnancy (3).


Imaging and Clinical Data of Placental Site Trophoblastic Tumor: A Case Report
Schematic features of the blastocyst and trophoblast. The blastocyst comprises an inner cell mass that subsequently forms the embryo and the outer layer called trophoblast that provides nutrients to the embryo and develops into a large part of the placenta.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5036456&req=5

fig32507: Schematic features of the blastocyst and trophoblast. The blastocyst comprises an inner cell mass that subsequently forms the embryo and the outer layer called trophoblast that provides nutrients to the embryo and develops into a large part of the placenta.
Mentions: Placental site trophoblastic tumor (PSTT) is a slow growing malignant intermediate trophoblastic tumor and a rare form of gestational trophoblastic disease (GTD) (1). PSTT is the least common form of gestational trophoblastic neoplasia composed of predominantly intermediate trophoblasts (Figure 1). Since 1981, about 150 cases have been reported in literature. The incidence of PSTT is about 1/100000 pregnancies and it constitutes about 1 - 2% of all GTDs (1). For the first time, Larsen et al. proposed the term of PSTT in 1991. It was considered as an exaggerated form of reaction of the placental bed (2). PSTT can occur several months, or even years, after the pregnancy including molar and ectopic, miscarriage and abortion, or a full term normal pregnancy (3).

View Article: PubMed Central - PubMed

ABSTRACT

Placental site trophoblastic tumor (PSTT) is a very rare variant of gestational trophoblastic tumor. It can occur after normal termination of pregnancy or spontaneous abortion and ectopic or molar pregnancy. There is a wide range of clinical manifestations from a benign condition to an aggressive disease with fatal outcome. One of the most important characteristics of PSTT, unlike other forms of gestational trophoblastic diseases (GTD) is the presence of low beta-subunit of human chorionic gonadotropin (β-hCG) levels because it is a neoplastic proliferation of intermediate trophoblastic cells. However, human placental lactogen (hPL) is increased on histologic section and in the serum of patients too. We present a case of PSTT and discuss the differential diagnosis in order to further familiarize physicians with the diagnosis and treatment of this disease. It has a varied clinical spectrum and usually presents with irregular vaginal bleeding or amenorrhea. Diagnosis is confirmed by dilatation and curettage (D and C) and hysterectomy. Because chemotherapy is not effective, surgery is the cornerstone of treatment. This case is presented because it is a rare neoplasm with different treatments and it should be differentiated from molar pregnancy.

No MeSH data available.