Placental site trophoblastic tumor. Report of three cases and review of the literature

Abstract

Three cases of placental site trophoblast tumor (PSTT) are added to 74 cases in the English language literature. One case presented with an anorexic syndrome, the other two with amenorrhea and abnormal vaginal bleeding. The three patients, whose lesions were confined to the uterus, were treated by total hysterectomy and their follow-up has been uneventful. Review of the literature showed that 62 patients with PSTT were alive and 15 had died, two as a complication of treatment. The diagnosis of PSTT may be difficult on a dilatation and currettage specimen. Metastases are a powerful indicator of adverse outcome. Prognosis, as assessed on pathologic criteria, is unreliable; however, a mitotic count of more than five mitoses per 10 high power fields is significant. Surgery is the mainstay of treatment. Hysterectomy is generally indicated, but young patients who wish to remain fertile may be treated by conservative surgery. In a few cases of progressive disease, chemotherapy has achieved remission, but generally chemotherapy and radiotherapy are ineffective. Long-term follow-up is essential as PSTT may progress after years of remission. Serum human chorionic gonadotrophin (hCG) levels are the best available marker of disease, but the disease may still progress even if hCG levels are not raised.

Absence of Y chromosome in human placental site trophoblastic tumor

“…8 Since then, additional case reports of placental site trophoblastic tumor have been published and again a female antecedent pregnancy was documented in 12 out of 14 new cases. [13][14][15] One cell line from a placental site trophoblastic tumor was established and confirmed by karyotyping to have XX genome. 16 However, the results of both our current and previous investiga- tions contrast to those of a recent genetic analysis of 23 placental site trophoblastic tumors, in which 50% of the tumors were found to contain a Y chromosome.…”

Long term remission of metastatic placental site trophoblastic tumor (PSTT): Case report and review of literature

“…Extrauterine spread of the disease appears to be the most useful prognostic factor for progression [19,20]. The interval from the last known antecedent pregnancy appears to be a second major prognostic variable in PSTT.…”

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

“…It is more probable that this is due to the absence of bHCG-secreting syncytiotrophoblastic epithelium in some of these tumors (6) . HPL is the predominantly expressed cell marker in PSTT, but its use as a tumor marker has been shown to be of little value in PSTT (7) .…”