Open AccessPlacental site trophoblastic tumour: the rarest subtype of gestational trophoblastic disease
Author(s) -
Mariana M Chaves,
Tiago Maia,
Teresa Margarida Cunha,
Vera Veiga
Publication year - 2020
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2020-235756
Subject(s) - placental site trophoblastic tumor , medicine , gestational trophoblastic disease , gynecology , hysterectomy , human chorionic gonadotropin , miscarriage , trophoblastic neoplasm , pregnancy , obstetrics , radiology , gestation , pathology , placenta , fetus , genetics , hormone , biology
Placental site trophoblastic tumour (PSTT) is a very rare form of gestational trophoblastic disease that grows slowly, secretes low levels of beta-subunit of human chorionic gonadotropin (β-hCG), presents late-onset metastatic potential and is resistant to several chemotherapy regimens. Here, we report a case of PSTT in a 36-year-old woman who presented with amenorrhea and persistently elevated serum level of β-hCG after a miscarriage. Transvaginal ultrasound revealed a hypovascular ill-defined solid lesion of the uterine fundus and MRI showed a tumour infiltrating the external myometrium with discrete early enhancement and signal restriction on diffusion-weighted imaging. PSTT was suspected, and after endometrial biopsy by hysteroscopy and posterior hysterectomy, microscopic examination allowed the final diagnosis. The level of β-hCG dropped significantly in about a month after surgical treatment. Due to the rarity of PSTT, reporting new cases is crucial to improve the diagnosis and managing of these patients.