Placental Site Trophoblastic Tumor: Successful Treatment of 13 Cases

Publication date: Available online 13 February 2020Source: Gynecologic Oncology ReportsAuthor(s): Amy L. Alexander, Anna E. Strohl, Kruti P. Maniar, John R. LurainAbstractPlacental site trophoblastic tumor (PSTT) is a rare variant of gestational trophoblastic neoplasia (GTN) that is characterized by slow growth resulting in mostly uterine-confined disease, low human chorionic gonadotropin (hCG) levels, and resistance to chemotherapy.Our objective was to update our center’s experience with PSTT with respect to presentation, prognostic factors, treatment, and outcomes from 2003 to 2019.Thirteen women with PSTT were identified. Mean age was 32 years. The most frequent presenting symptom was abnormal uterine bleeding (69%). A uterine mass was noted in 62%. The diagnosis was usually established by endometrial biopsy or curettage (62%). Nonmolar pregnancy was the preceding gestation in 85%. Median time from last pregnancy to diagnosis was 13 months (range 0-240 months). Serum hCG levels at diagnosis ranged from 1-2606 mIU/mL (median 98 mIU/mL). Three women (23%) presented with metastatic disease. All 13 women underwent surgery: 12 had a hysterectomy, 1 had a fertility-sparing hysteroscopic resection, and 2 underwent pulmonary metastatectomy. Nine women (69%) also received chemotherapy for persistently elevated hCG levels after hysterectomy (2), high-risk factors (4), or metastatic disease (3). Overall survival was 100% with a median survival of 65 months (range 30-167 months).Sur...
Source: Gynecologic Oncology Reports - Category: OBGYN Source Type: research