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- Title
Placental Site Trophoblastic Tumor.
- Authors
Acharya, Geeta; Premalatha, T. S.; Kulkarni, Kiran A.
- Abstract
INTRODUCTION- Placental site trophoblastic tumor (PSTT) is a rare form of gestational trophoblastic disease accounting for 1-2% of trophoblastic tumors. Common presentation is irregular vaginal bleeding. PSTT originates from the intermediate trophoblasts in the placenta. Age >35 years, interval since antecedent pregnancy of over 2 years, deep myometrial invasion, stage III or IV, maximum hCG level >1, 000IU/L, extensive coagulative necrosis, high mitotic rate, and the presence of cells with clear cytoplasm were signi?cant prognostic factors. The standard treatment for PSTT is hysterectomy as it is fairly resistant to chemotherapy. Single agent chemotherapy is not effective for PSTT and a regimen of multiagent chemotherapy for choriocarcinoma (EMA/CO, MEA, EP/EMA) is recommended. CASE REPORT- A 35-year-old P3L3 woman presented with 2 months of heavy menstrual bleeding. Her last pregnancy was delivered by spontaneous vaginal delivery 11 years ago She was tubectomised. On examination she had mass protruding through cervical Os and 10 weeks uterus. Ultrasound and MRI showed 9x8 cms heterogenous mass protruding in the cervical canal. Inital beta hcg was 9498. HPR of the mass showed PSTT. She was treated with total abdominal hysterectomy and retroperitoneal lymphnode dissection. Immunohistochemistry showed a mixed intermediate trophoblastic tumour with components of epithelioid trophoblastic tumour and placental site trophoblastic tumour. She received 6 cycles of adjuvant chemotherapy with etoposide, methotrexate, actinomycin, and cisplatin (EMA-EP). On follow up patient is disease free for 9 months.
- Subjects
TROPHOBLASTIC tumors; GESTATIONAL trophoblastic disease; HYSTERO-oophorectomy; ADJUVANT treatment of cancer; UTERINE hemorrhage; ACTINOMYCIN
- Publication
Journal of Cancer Research & Therapeutics, 2017, Vol 13, pS323
- ISSN
0973-1482
- Publication type
Article