Placental site trophoblastic tumor: A study of 55 cases and review of the literature emphasizing factors of prognostic significance

Baergen, Rebecca N.; Rutgers, Joanne L.; Young, Robert H.; Osann, Kathryn; Scully, Robert E.

doi:10.1016/j.ygyno.2005.08.058

Cited by 189 publications

(150 citation statements)

References 89 publications

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“…One unlikely explanation is that placental site trophoblastic tumor might derive from an antecedent complete hydatidiform mole, a comparatively more common gestational trophoblastic disease with uniparental disomy of the paternal genome and an exclusive paternal X chromosome. However, only a small percentage of placental site trophoblastic tumors have been reported to follow the development of complete mole 1,2 . Alternatively, our data suggest an active role for the paternal X chromosome in the pathogenesis of placental site trophoblastic tumor, although the mechanistic contribution of this chromosome to tumor growth is unclear.…”

Section: Discussionmentioning

confidence: 99%

“…The majority of the tumors pursue a benign clinical course; however, clinically malignant cases exist with an estimated mortality rate of 15%. 2 Treatment of placental site trophoblastic tumor is mainly surgical, but successful multidrug chemotherapy has been recently reported in some aggressive cases. 3 At cytogenetic level, most of the tumors analyzed have been diploid 4,5 and rarely showed genetic imbalances analyzed by comparative genomic hybridization.…”

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confidence: 99%

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Absence of Y chromosome in human placental site trophoblastic tumor

et al. 2007

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Placental site trophoblastic tumor is a neoplasm of extravillous intermediate trophoblast at the implantation site, preceded in the majority of cases by a female gestational event. Our pilot investigation suggested that the development of this tumor might require a paternally derived X chromosome and the absence of a Y chromosome. Twenty cases of placental site trophoblastic tumor were included in this study. Genotyping at 15 polymorphic loci and one sex determination locus was performed by multiplex PCR followed by capillary electrophoresis. X chromosome polymorphisms were determined by PCR amplification of exon 1 of the human androgen receptor gene using primers flanking the polymorphic CAG repeats within this region. Genotyping at 15 polymorphic loci was informative and paternal alleles were present in all tumors, confirming the trophoblastic origin of the tumors. The presence of an X chromosome and the absence of a Y chromosome were observed in all tumors. Among 13 cases in which analysis of the X chromosome polymorphism was informative, all but one demonstrated at least two X alleles and seven cases showed one identifiable paternal X allele. These results confirm a unique pathogenetic mechanism in placental site trophoblastic tumor, involving an exclusion of the Y chromosome from the genome and, therefore, a tumor arising from the trophectoderm of a female conceptus. As epigenetic regulations of imprinting during X chromosome inactivation are of significant biological implications, placental site trophoblastic tumor may provide an important model for studying the sex chromosome biology and the proliferative advantage conferred by the paternal X chromosome.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Absence of Y chromosome in human placental site trophoblastic tumor

et al. 2007

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“…9 They are characterized with a vascular invasion, a necrosis, and hemorrhage at a lesser extent than choriocarcinoma, and a bigger tendency to disseminate through the lymphatic track.…”

Section: Discussionmentioning

confidence: 99%

Malignant placental trophoblastic tumour a diagnostic dilemma: rare association with focal segmental glomerulonephritis and cardiomyopathy

Patel¹,

Vyas²,

Vaishnav³

2017

Int J Reprod Contracept Obstet Gynecol

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Placental site trophoblastic tumour (PSTT) is the rarest form of Gestational trophoblastic neoplasia (GTN).It has a wide clinical spectrum of presentation and its complications have a multi organ involvment. Inspite of the advances in HCG assays and sensitive unltrasounds, its diagnosis and course in every case is a mystery. However, it is only rarely associated with glomerulonephritis. Most cases have not been biopsied and the specific nature of renal involvement is not clearly understood. Here we report a case of PSTT with glomerulonephritis and cardiomyopathy.

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“…In a review of 62 PSTT women treated at three gestational trophoblastic disease centres in United Kingdom, 23% patients died resulting in a probability of overall survival of 73% at 5 years and 70% at 10 years [6]. Previous reports have demonstrated that age older than 35 years, deep myometrial invasion (>1/2), high mitotic rate (>5 per 10 HPF), clear cytoplasm, coagulative necrosis, vascular space involvement, prior term pregnancy, and increased interval from previous pregnancy are important factors in the prognosis of these tumors [7]. However, Schmid et al reported that only time (>48 months) since antecedent pregnancy remained significantly associated with multivariate analyses after adjustment for the FIGO score [6].…”

Section: Discussionmentioning

confidence: 99%

A rare cause for gestational trophoblastic neoplasia: Placental site trophoblastic tumor

Ülker¹,

Akyol²,

Gedikbaşı³

et al. 2013

OJOG

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Placental site trophoblastic tumor is a rare sub-group of gestational trophoblastic neoplasia. There is a wide clinical spectrum of presentation and behaviour ranging from a benign condition to an aggressive disease with a fatal outcome. We report a case of placental site trophoblastic tumor in 23-year-old women with irregular vaginal bleeding during postpartum lactation period. In addition to persistent low level B-hCG titers, ultrasound examination revealed a suspicious low-echoic area in the myometrium consistent with gestational trophoblastic disease. After histopathological examination of the specimen achieved by ultrasound-guided dilatation and curettage of the uterus, the placental site trophoblastic tumor diagnosis was made and subsequently total abdominal hysterectomy was performed. The patient had an uneventful recovery, and no recurrence was detected for 40 months in the follow-up period.

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Placental site trophoblastic tumor: A study of 55 cases and review of the literature emphasizing factors of prognostic significance

Cited by 189 publications

References 89 publications

Absence of Y chromosome in human placental site trophoblastic tumor

Absence of Y chromosome in human placental site trophoblastic tumor

Malignant placental trophoblastic tumour a diagnostic dilemma: rare association with focal segmental glomerulonephritis and cardiomyopathy

A rare cause for gestational trophoblastic neoplasia: Placental site trophoblastic tumor

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