Placental Site Trophoblastic Tumor: A Case Report and Review of the Literature

Abstract

Placental site trophoblastic tumor is rare. They represent a rare form of gestational trophoblastic disease. They occur mainly in women who have a history of miscarriage, termination of pregnancy, or even a normal or pathological ongoing pregnancy. The clinical course is unpredictable. This malignancy has different characteristics from other gestational trophoblastic tumors. Following a clinical case that we encountered and treated, we conducted a literary research and review, focusing primarily on prognostic factors and treatment.

Uterine curettage prior to supracervical hysterectomy identifies a placental trophoblastic tumor – a case study

“…PSTT tumors are unique and difficult to diagnose. Only 300 PSTT cases have been described with confirmed histopatholgy since 1976 [9]. This may be due to the fact that concurrent PSTT isn't taken into account prior to planning for uterine fibroid surgery.…”

Outcomes of women diagnosed and treated for low‐risk gestational trophoblastic neoplasia at the Queensland Trophoblast Centre (QTC)

“…The woman who developed disease relapse was initially diagnosed with a complete hydatidiform mole and was diagnosed with PSTT only after her second relapse. It is worthwhile to remember that PSTT can occur after any pregnancy event and poor prognostic factors include metastatic disease, interval from antecedent pregnancy to presentation, a term birth for the last pregnancy and a serum Bhcg level higher than 1000 IU/L . A diagnosis of PSTT should be considered if a patient with GTN relapses.…”

“…Most studies report an increase in nausea and dermatological toxicity when using actinomycin D . While 64.7% of women complained of nausea, this generally occurred in cycle one and was easily managed with anti‐emetics; 50% of women treated with first‐line MTX also reported nausea.…”

Management of placental site trophoblastic tumor

“…Malignant forms of GTD include Invasive mole, PSTT, Epithelioid trophoblastic tumor (ETT) and Choriocarcinoma (CC). [1,2] Notably, no more than 300 cases of PSTT have been reported until now, [3,4] with an incidence of about 1/50,000–100,000 pregnancies covering a percentage from 0.23% to 3.00% of all GTDs. [1,2,5]…”

“…[7] Moreover, PSSTs occur often in patients with a previous miscarriage, a termination of pregnancy or an ongoing pregnancy, either normal or pathological. [4] However, PSTTs differ deeply from other GTDs due to the biological characteristics, clinical behavior, slow growth and a relative resistance to chemotherapy, [7] requiring peculiar diagnostic strategies and therapeutic options.…”