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Case report
Placental site trophoblastic tumour: the rarest subtype of gestational trophoblastic disease
  1. Mariana M Chaves1,
  2. Tiago Maia2,
  3. Teresa Margarida Cunha3 and
  4. Vera Furtado Veiga4
  1. 1Radiology, Hospital do Divino Espirito Santo de Ponta Delgada EPE, Ponta Delgada, Portugal
  2. 2Pathology, Instituto Português de Oncologia de Lisboa Francisco Gentil EPE, Lisboa, Portugal
  3. 3Radiology, Instituto Português de Oncologia de Lisboa Francisco Gentil EPE, Lisbon, Portugal
  4. 4Gynecology, Instituto Português de Oncologia de Lisboa Francisco Gentil EPE, Lisboa, Portugal
  1. Correspondence to Dr Mariana M Chaves; m.m.chvs{at}gmail.com

Abstract

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.

  • gynecological cancer
  • radiology
  • pathology
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Footnotes

  • Contributors MMC developed the concept, captured the images and wrote the manuscript with input from all authors; TM performed the pathological analysis and captured the histological and surgical specimen pictures; TMC captured the images and gave expert opinion and VFV contributed in the management of the patient. All authors approved the final version of the manuscript for submission.

  • 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.

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