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The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
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Obstetrics and Gynegology2020№12
Placental site trophoblastic tumor

Placental site trophoblastic tumor

DOI
https://dx.doi.org/10.18565/aig.2020.12.223-229

Verenikina E.V., Moiseenko T.I., Menshenina A.P., Nepomnyashchaya E.M., Adamyan M.L. Meshcheryakova M.Yu.

National Medical Research Centre for Oncology, Ministry of Health of Russia, Rostov-on-Don, Russia
Background. Placental site trophoblastic tumor (PSTT) is a nonvillous tumor originating from the placental part of trophoblast. This pathology was first described in 1976; only 300 cases of this disease are known to date. PSTT develops in reproductive-aged women and is noted for a relatively slow growth rate; morphologically, it is a monomorphic mass originating from intermediate trophoblast cells with signs of syncytiotrophoblast and cytotrophoblast. PSTT is characterized by a slow rise in blood β-hCG levels. The diagnosis of PSTT remains relevant: the rate of its misdiagnosis amounts to as much as 40%. In addition, there are problems with chemotherapy, which is why surgical treatment comes to the fore.
Case report. In 2013, Patient A. aged 30 years had a second premature labor without complications. Her menstrual cycle did not resume after lactation cessation. Diagnostic curettage of the uterine cavity was performed in the National Medical Research Center for Oncology. Histological examination revealed intermediate trophoblast layers in the complete absence of chorionic villi. The histological findings and clinical presentations corresponded to Stage I PSTT. In this connection, an extended extirpation of the uterus with fallopian tubes was recommended. The β-hCG level decreased to 5.6 mIU/ml just 12 days after surgery and it was 0.06 mIU/ml one month later.
Conclusion. The diagnosis of PSTT is accompanied by a problem in the medical treatment of this disease due to an extremely low sensitivity to chemotherapeutic agents. It is usually sufficient to carry out uterine extirpation if metastases are absent. In the clinical case demonstrated, the patient’s condition remained stable during the follow-up period of 44 months in the postoperative period and there were no signs of progression. Thus, early diagnosis is of great importance when the tumor is limited to the uterus and can be radically removed.

Keywords

gestational trophoblastic disease
placental site trophoblastic tumor
Full text (in Russian)

References

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Received 09.09.2020

Accepted 17.11.2020

About the Authors

Ekaterina V. Verenikina, Cand. Med. Sci., Head of the Department of Oncogynecology, National Medical Research Centre for Oncology. Tel.: +7(863)300-02-00 ext. 380. E-mail: ekat.veren@yandex.ru. ORCID: 0000-0002-1084-5176. Russia, 344037, Rostov-on-Don; 14th Liniya str., 63.
Tatiana I. Moiseenko, Dr. Med. Sci., Professor, chief researcher, Department of Reproductive Tumors, National Medical Research Centre for Oncology.
Tel.: +7(863)300-02-00 ext. 382. E-mail: moiseenko48@inbox.ru. ORCID: 0000-0003-4037-7649. Russia, 344037, Rostov-on-Don; 14th Liniya str., 63.
Anna P. Menshenina, Cand. Med. Sci., leading researcher, Department of Reproductive Tumors, National Medical Research Centre for Oncology.
Tel.: +7(863)300-02-00 ext. 381. E-mail: anna.menshenina.00@mail.ru. ORCID: 0000-0002-7968-5078. Russia, 344037, Rostov-on-Don; 14th Liniya str., 63.
Evgenia M. Nepomnyashchaya, Dr. Med. Sci., Professor, leading researcher, Department of Anatomic Pathology, National Medical Research Centre for Oncology.
Tel.: +7(863)300-02-00 ext. 574. E-mail: rnioi-patology@yandex.ru. ORCID: 0000-0003-0521-8837. Russia, 344037, Rostov-on-Don; 14th Liniya str., 63.
Meri L. Adamyan, researcher, Department of Reproductive Tumors, National Medical Research Centre for Oncology. Tel.: +7(863)300-02-00 ext. 381.
E-mail: adamyan.meri@mail.ru. ORCID: 0000-0003-4188-3746. Russia, 344037, Rostov-on-Don; 14th Liniya str., 63.
Milana Yu. Meshcheryakova, fellow doctor, National Medical Research Centre for Oncology. Tel.: +7(989)710-87-31.
E-mail: mesheryakovamilana@mail.ru. ORCID: 0000-0002-6003-4291. Russia, 344037, Rostov-on-Don; 14th Liniya str., 63.

For citation: Verenikina E.V., Moiseenko T.I., Menshenina A.P., Nepomnyashchaya E.M., Adamyan M.L. Meshcheryakova M.Yu. Placental site trophoblastic tumor.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2020; 12: 223-229 (in Russian)
https://dx.doi.org/10.18565/aig.2020.12.223-229
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