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Case report
Placental site trophoblastic tumour: five challenges of patient clinical management
  1. Catarina Peixinho1,
  2. Amélia Almeida2,
  3. Carla Bartosch3 and
  4. Mónica Cruz Pires4
  1. 1Department of Gynecology and Obstetrics, Hospital Pedro Hispano, Matosinhos, Portugal
  2. 2Department of Gynecology and Obstetrics, Centro Hospitalar do Médio Ave, Famalicão, Portugal
  3. 3Department of Pathology, Instituto Portugues de Oncologia do Porto Francisco Gentil EPE, Porto, Portugal
  4. 4Department of Gynecology, Instituto Portugues de Oncologia do Porto Francisco Gentil EPE, Porto, Portugal
  1. Correspondence to Dr Catarina Peixinho; catarina.peixinho1989{at}gmail.com

Abstract

Placental site trophoblastic tumour is a rare form of gestational trophoblastic disease accounting for about 1%–2% of all trophoblastic tumours. Diagnosis and management of placental site trophoblastic tumour can be difficult.

We report a case of a 30-year-old woman diagnosed with a placental site trophoblastic tumour and identify the challenges in diagnosis and treatment of this rare situation. The presenting sign was abnormal vaginal bleeding that started 3 months after delivery. Image exams revealed an enlarged uterus with a heterogeneous mass, with vesicular pattern, and the increased vascularisation serum human chorionic gonadotropin level was above normal range. The histological diagnosis was achieved through hysteroscopic biopsy. Staging exams revealed pulmonary micronodules. The patient was successfully treated with hysterectomy and chemotherapy. The latest follow-up (37 months after diagnosis) was uneventful, and the patient exhibited no signs of recurrence or metastasis.

  • cancer - see oncology
  • pregnancy
  • pathology

https://doi.org/10.1136/bcr-2020-238994

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    Footnotes

    • Contributors CP, CB and MCP wrote the manuscript conceived and designed the manuscript. CB analysed and interpreted the histopathological tissue and select all the images to describe each tissue. AA guided initial diagnosis and later guidance to the oncology centre and selected all the ultrasound images represented in the article. All authors read and approved the final version of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.