Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Placental-site trophoblastic tumors: a case of resistant pulmonary metastasis

Abstract

Background A 52-year-old woman whose last known pregnancy was 12 years before presentation was diagnosed with mixed trophoblastic tumor that included placental-site trophoblastic tumor, epithelioid trophoblastic tumor, and focal choriocarcinoma. There was no clear evidence of metastatic disease on initial evaluation.

Investigations Histopathology, laboratory tests, immunohistochemistry, chest X-ray, CT scan of the chest, abdomen, and pelvis, fine-needle aspiration biopsy, PET-CT scan.

Diagnosis Metastatic chemoresistant placental-site trophoblastic tumor positive for EGFR, VEGF receptor, and platelet-derived growth factor receptor.

Management Abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic radiation, etoposide, methotrexate, actinomycin D/cyclophosphamide and vincristine chemotherapy, left thoracotomy with wedge resection, taxol, etoposide, cisplatin therapy, right thoracotomy with wedge resection.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Figure 1: Chest CT scan of the patient.
Figure 2: Morphology of mixed trophoblastic tumor.
Figure 3: Hematoxylin and eosin staining of placental-site trophoblastic tumor.

References

  1. Escobar PF et al. (2003) Treatment of high risk gestational trophoblastic neoplasia with etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine chemotherapy. Gynecol Oncol 91: 552–557

    Article  CAS  Google Scholar 

  2. Ajithkumar TV et al. (2003) Placental site trophoblastic tumor. Obstet Gynecol Surv 58: 484–488

    CAS  PubMed  Google Scholar 

  3. Wani AA et al. (2004) Placental site trophoblastic tumor: a case of extensive pulmonary metastasis. Chest 126: S990–S991

    Article  Google Scholar 

  4. Bettencourt E et al. (1997) Placental site trophoblastic: the value of transvaginal color and pulsed Doppler sonography in its diagnosis: case report. Eur J Gynaecol Oncol 18: 461–464

    CAS  PubMed  Google Scholar 

  5. Brandt KR and Coakley KJ (1998) MR appearance of placental site trophoblastic tumor: a report of three cases. AJR Am J Roentgenol 170: 485–487

    Article  CAS  Google Scholar 

  6. Bajka M et al. (1995) Transvaginal ultrasound of “placental site trophoblastic tumor”[German]. Gynakol Geburtshilfliche Rundsch 35: 38–41

    Article  CAS  Google Scholar 

  7. Begent RHJ (1995) Gestational trophoblastic tumors. In Oxford Textbook of Oncology, Vol 2, 1363–1378 (Eds Peckha. et al.) Oxford: Oxford University Press

    Google Scholar 

  8. Bently RC (2003) Pathology of gestational trophoblastic disease. Clin Obstet Gynecol 46: 513–522

    Article  Google Scholar 

  9. Shih IM and Kurman RJ (2002) Molecular basis of gestational trophoblastic diseases. Curr Mol Med 2: 1–12

    Article  CAS  Google Scholar 

  10. Cole LA et al. (2006) Gestational trophoblastic diseases: pathophysiology of hyperglycosylated hCG. Gynecol Oncol 102: 145–150

    Article  CAS  Google Scholar 

  11. Shih IM and Kurman RJ (2004) p63 expression is useful in the distinction of epithelioid and placental site trophoblastic tumors by profiling trophoblastic subpopulations. Am J Surg Pathol 28: 1177–1183

    Article  Google Scholar 

  12. Feltmate CM et al. (2001) Placental site trophoblastic tumor: a 17-year experience at the New England Trophoblastic Disease Center. Gynecol Oncol 82: 415–419

    Article  CAS  Google Scholar 

  13. Finkler NJ et al. (1988) Clinical experience with placental site trophoblastic tumors at the New England Trophoblastic Disease Center. Obstet Gynecol 71: 854–857

    CAS  PubMed  Google Scholar 

  14. Vardar MA and Altintas A (1995) Placental site trophoblastic tumor: principles of diagnosis, clinical behavior, and treatment. Eur J Gynaecol Oncol 16: 290–295

    CAS  PubMed  Google Scholar 

  15. Leiserowitz GS and Webb MJ (1996) Treatment of placental site trophoblastic tumor hysterotomy and uterine reconstruction. Obstet Gynecol 88: 696–699

    Article  CAS  Google Scholar 

  16. Lathrop JC et al. (1988) Clinical characteristics of placental site trophoblastic tumor (PSTT). Gynecol Oncol 31: 32–42

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michael E Cole.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cole, M., Broaddus, R., Thaker, P. et al. Placental-site trophoblastic tumors: a case of resistant pulmonary metastasis. Nat Rev Clin Oncol 5, 171–175 (2008). https://doi.org/10.1038/ncponc1042

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ncponc1042

This article is cited by

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing