Metastatic Placental Site Trophoblastic Tumor: A Case Report
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Abstract Placental site trophoblastic tumor (PSTT) is very rare. It is an unusual variant of gestational trophoblastic neoplasia usually confined to the uterus, although 10% of patients have metastases. The clinical behaviour of PSTT varies and despite knowledge of its histology, diagnosis of this rare form of trophoblastic disease and prediction of its biological behaviour remains difficult due to only a few cases reported in literature.Keywords:
Gestational Trophoblastic Disease
Trophoblastic Tumor
Gestational trophoblastic neoplasia
Trophoblastic neoplasm
Histology
Placenta Diseases
Molar Pregnancy
Gestational trophoblastic neoplasia
Gestational Trophoblastic Disease
Trophoblastic Tumor
Partial Hydatidiform Mole
Trophoblastic neoplasm
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Abstract Placental site trophoblastic tumor (PSTT) is very rare. It is an unusual variant of gestational trophoblastic neoplasia usually confined to the uterus, although 10% of patients have metastases. The clinical behaviour of PSTT varies and despite knowledge of its histology, diagnosis of this rare form of trophoblastic disease and prediction of its biological behaviour remains difficult due to only a few cases reported in literature.
Gestational Trophoblastic Disease
Trophoblastic Tumor
Gestational trophoblastic neoplasia
Trophoblastic neoplasm
Histology
Placenta Diseases
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Gestational trophoblastic disease is a spectrum of interrelated abnormal proliferations of the placental trophoblast, encompassing benign hydatidiform moles (complete and partial) as well as gestational trophoblastic neoplasia, which includes invasive mole, choriocarcinoma, placental site trophoblastic tumor, and its related epithelioid trophoblastic tumor. Early detection of hydatidiform moles with ultrasonography and advances in uterine evacuation techniques have decreased serious bleeding and medical complications of molar pregnancy. The availability of accurate tests for measuring human chorionic gonadotropin as a disease-specific tumor marker and the introduction of chemotherapy into the management of gestational trophoblastic neoplasia have significantly reduced deaths so that the overall cure rate in treating these tumors is greater than 90% even in the presence of widely metastatic disease.
Partial Hydatidiform Mole
Gestational Trophoblastic Disease
Trophoblastic Tumor
Molar Pregnancy
Gestational trophoblastic neoplasia
Human chorionic gonadotropin
Trophoblastic neoplasm
Trophoblast
Gonadotropin
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Gestational trophoblastic disease is a spectrum of abnormal proliferations of the placental trophoblast encompassing four main clinicopathologic forms: hydatidiform mole (complete and partial), invasive mole, choriocarcinoma, and placental site trophoblastic tumor and its related epithelioid trophoblastic tumor. The latter three conditions are collectively referred to as gestational trophoblastic neoplasia and have varying degrees of malignant potential. Early detection of hydatidiform moles with ultrasonography, advances in uterine evacuation techniques, the use of human chorionic gonadotropin as a disease-specific tumor marker, and the introduction of chemotherapy into the management of gestational trophoblastic neoplasia has significantly decreased the risk of death from gestational trophoblastic disease. This chapter will describe the epidemiology, pathology, clinical presentation and diagnosis of each of these trophoblastic disease variants.
Gestational Trophoblastic Disease
Partial Hydatidiform Mole
Trophoblastic Tumor
Gestational trophoblastic neoplasia
Human chorionic gonadotropin
Trophoblastic neoplasm
Trophoblast
Molar Pregnancy
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Gestational Trophoblastic Disease
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Trophoblastic Tumor
Gestational trophoblastic neoplasia
Trophoblastic neoplasm
Gestational Trophoblastic Disease
Partial Hydatidiform Mole
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Placental site trophoblastic tumor (PSTT) is the rare variant of gestational trophoblastic diseases (GTD), which differs histologically and immunologically from GTD. Diagnosis of PSTT is often difficult and delayed. In most cases, diagnosis is not possible until the surgery is performed. The most therapeutic choice is hysterectomy and it is usually successful. Here we report two cases of PSTT.
Trophoblastic Tumor
Trophoblastic neoplasm
Placenta Diseases
Gestational Trophoblastic Disease
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Gestational Trophoblastic Disease
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This chapter provides the background information of the gestational trophoblastic disease (GTD), and discusses its prevention, diagnosis, treatment, and prognosis. GTD comprises a spectrum of premalignant to malignant conditions that originate from the placenta. Histologically distinct diseases within the spectrum of GTD include complete and partial hydatidiform moles (premalignant) to invasive moles, gestational choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor. Effective birth control can prevent this disease. The most common symptom is abnormal vaginal bleeding. Transvaginal ultrasonography is used to establish the diagnosis of molar pregnancy in combination with abnormally high level of human chorionic gonadotropin (hCG) (>100 000 mIU/mL). Serial monitoring of hCG is used for identification of postmolar gestational trophoblastic neoplasia. Patients with nonmetastatic GTN (Stage I) or low-risk metastatic GTN (Stage II or III) can be treated with single-agent chemotherapy.
Gestational Trophoblastic Disease
Trophoblastic Tumor
Molar Pregnancy
Partial Hydatidiform Mole
Gestational trophoblastic neoplasia
Human chorionic gonadotropin
Vaginal bleeding
Trophoblastic neoplasm
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Placental site trophoblastic tumor (PSTT) is the rarest form of Gestational Trophoblastic Neoplasia (GTN). We present this case of uterine PSTT to illustrate the difficulties in the diagnosis of this tumor and how this led to delay in its appropriate management..
Trophoblastic Tumor
Gestational trophoblastic neoplasia
Trophoblastic neoplasm
Placenta Diseases
Gestational Trophoblastic Disease
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