سامانه مدیریت نشریات علمی دانشگاه علوم پزشکی مشهد

Adepiti, Clement, Ubom, Akaninyene, Awowole, Ibraheem, Ajenifuja, Kayode. (1403). Placental site trophoblastic tumor: report of successful management with combination chemotherapy, subsequent spontaneous conception, and a live birth at term. , 12(1), 34-40. doi: 10.22038/rcm.2025.80311.1497
Clement A Adepiti; Akaninyene Eseme Ubom; Ibraheem Olayemi Awowole; Kayode Olusegun Ajenifuja. "Placental site trophoblastic tumor: report of successful management with combination chemotherapy, subsequent spontaneous conception, and a live birth at term". , 12, 1, 1403, 34-40. doi: 10.22038/rcm.2025.80311.1497
Adepiti, Clement, Ubom, Akaninyene, Awowole, Ibraheem, Ajenifuja, Kayode. (1403). 'Placental site trophoblastic tumor: report of successful management with combination chemotherapy, subsequent spontaneous conception, and a live birth at term', , 12(1), pp. 34-40. doi: 10.22038/rcm.2025.80311.1497
Adepiti, Clement, Ubom, Akaninyene, Awowole, Ibraheem, Ajenifuja, Kayode. Placental site trophoblastic tumor: report of successful management with combination chemotherapy, subsequent spontaneous conception, and a live birth at term. , 1403; 12(1): 34-40. doi: 10.22038/rcm.2025.80311.1497

Placental site trophoblastic tumor: report of successful management with combination chemotherapy, subsequent spontaneous conception, and a live birth at term

Reviews in Clinical Medicine
مقاله 6، دوره 12، شماره 1، خرداد 2025، صفحه 34-40    اصل مقاله (1.02 M)
نوع مقاله: Case report
شناسه دیجیتال (DOI): 10.22038/rcm.2025.80311.1497
نویسندگان
Clement A Adepiti* 1؛ Akaninyene Eseme Ubom2؛ Ibraheem Olayemi Awowole3؛ Kayode Olusegun Ajenifuja4
1Department of Obstetrics and Gynaecology, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
2Department of Obstetrics and Gynaecology, Obafemi Awolowo University Teaching Hospitals' Complex, Ile-Ife, Osun state, Nigeria
3Department of Obstetrics and Gynaecology, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
4Department of Obstetrics, Gynaecology, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
چکیده
Introduction: Placental site trophoblastic tumor (PSTT) is a rare form of gestational trophoblastic disease (GTD) that is usually associated with high mortality compared to the other subtypes because of its unpredictable biological behavior, less responsiveness to chemotherapy, and poor prognosis.
Case Presentation: We present a 27year old nulliparous lady referred to our centre for recurrent vaginal bleeding following two evacuations for an incomplete spontaneous miscarriage after eight weeks of amenorrhea. Her assessment revealed low serum beta-human chorionic gonadotropin (βhCG) and high human placental lactogen (hPL) levels. Ultrasound scan and Doppler study showed a highly vascular tumor infiltrating the myometrium. She strongly desired to preserve her fertility and was initially commenced on low dose Methotrexate with marginal reduction in tumor volume and resistance on higher dose. She responded well to combination chemotherapy and the tumor disappeared after the second course. She received three additional courses and was followed up with serial ultrasonography for one year. She subsequently conceived spontaneously, with vaginal delivery of a live, normal female baby at term.
Conclusion: Though hysterectomy combined with chemotherapy is the recommended management for PSTT and serum hPL is the usual tumor marker for follow-up, we present a case of successful treatment with combination chemotherapy alone and follow-up with subsequent cure, spontaneous conception, and delivery of a live baby.
کلیدواژه‌ها
Placental site trophoblastic tumor؛ gestational trophoblastic disease؛ chemotherapy؛ ultrasound؛ human placenta lactogen
مراجع
  1. Kurman RJ. The morphology, biology, and pathology of intermediate trophoblast: a look back to the present. Hum Pathol. 1991 Sep;22(9):847-55.
    doi:10.1016/0046-8177(91)90173-M
    [PMid:1655617]
  2. Kohorn EL. Worldwide survey of the results of treating gestational trophoblastic disease. J Reprod Med. (2014) 59:145-53.
  3. Braga A, Uberti EM, Fajardo Mdo C, Viggiano M, Sun SY, Grillo BM, et al. Epidemiological report on the treatment of patients with gestational trophoblastic disease in 10 Brazilian referral centers: results after 12 years since International FIGO 2000 Consensus. J Reprod Med. (2014) 59: 241-7. 12.
  4. van Trommel NE, Lok CA, Bulten H, Thomas CM, Massuger LF. Long-term outcome of placental site trophoblastic tumor in The Netherlands. J Reprod Med. (2013) 58: 224-8. 13.
  5. Rhoton-Vlasak A, Wagner JM, Rutgers JL, Baergen RN, Young RH, Roche PC, et al. Placental site trophoblastic tumor: human placental lactogen and pregnancy-associated major basic protein as immunohistologic markers. Hum Pathol. (1998) 29:280-8.doi:10.1016/S0046-8177(98)90048-X
    [PMid:9496832]
  6. Kar A, Mishra C, Biswal P, Kar T, Panda S, Naik S. Differential expression of cyclin E, p63, and Ki-67 in gestational trophoblastic disease and its role in diagnosis and management: A prospective case-control study. Indian J Pathol Microbiol. (2019) 62: 54-60. doi: 10.4103/IJPM.IJPM_82_18 62.
    doi:10.4103/IJPM.IJPM_82_18
    [PMid:30706860]
  7. Moore-Maxwell CA, Robboy SJ. Placental site trophoblastic tumor arising from antecedent molar pregnancy. Gynecol Oncol. 2004 Feb;92(2):708-12. doi: 10.1016/j.ygyno.2003.10.048. PMID: 14766272.
    doi:10.1016/j.ygyno.2003.10.048
    [PMid:14766272]
  8. Zhao J, Lv WG, Feng FZ, Wan XR, Liu JH, Yi XF, et al. Placental site trophoblastic tumor: a review of 108 cases and their implications for prognosis and treatment. Gynecol Oncol. (2016) 142:102-8. doi: 10.1016/j.ygyno.2016.05.006.
    doi:10.1016/j.ygyno.2016.05.006
    [PMid:27168005]
  9. Burkett WC, Soper JT. A Review of Current Management of Placental Site Trophoblastic Tumor and Epithelioid Trophoblastic Tumor. Obstet Gynecol Surv. 2022 Feb;77(2):101-110. doi: 10.1097/OGX.0000000000000978. PMID: 35201361.
    doi:10.1097/OGX.0000000000000978
    [PMid:35201361]
  10. Wang V, Elias KM, Berkowitz RS, Horowitz NS. Placental Site Trophoblastic Tumors and Epithelioid Trophoblastic Tumors. Hematol Oncol Clin North Am. 2024 Dec;38(6):1277-1286. doi: 10.1016/j.hoc.2024.08.016. Epub 2024 Sep 24. PMID: 39322463.
    doi:10.1016/j.hoc.2024.08.016
    [PMid:39322463]
  11. Zhou Y, Lu H, Yu C, Tian Q, Lu W. Sonographic characteristics of placental site trophoblastic tumor. Ultrasound Obstet Gynecol. (2013) 41:679-84. doi: 10.1002/uog.12269 77.
    doi:10.1002/uog.12269
    [PMid:22807194]
  12. Shaaban AM, Rezvani M, Haroun RR, Kennedy AM, Elsayes KM, Olpin JD, et al. Gestational trophoblastic disease: clinical and imaging features. Radiographics. (2017) 37:681-700. doi: 10.1148/rg.20171 60140.
    doi:10.1148/rg.2017160140
    [PMid:28287945]
  13. Feng X, Wei Z, Zhang S, Du Y, Zhao H. A review on the pathogenesis and clinical management of placental site trophoblastic tumors. Front Oncol 2019; 9: 937.
    doi:10.3389/fonc.2019.00937
    [PMid:31850188]
  14. Deng L, Zhang J, Wu T, Lawrie TA. Combination chemotherapy for primary treatment of high-risk gestational trophoblastic tumor. Cochrane Database Syst Rev 2013; 2013(1): CD005196.
    doi:10.1002/14651858.CD005196.pub4
    [PMid:23440800]
  15. Zeng X, Liu X, Tian Q, Xue Y, An R. Placental site trophoblastic tumor: A Case Report and Literature Review. Intractable Rare Dis Res. 2015 Aug;4(3):147-51. doi: 10.5582/irdr.2015.01013. PMID: 26361566; PMCID: PMC4561244.
    doi:10.5582/irdr.2015.01013
    [PMid:26361566]
  16. Chiofalo B, Palmara V, Laganà AS, Triolo O, Vitale SG, Conway F, Santoro G. Fertility Sparing Strategies in Patients Affected by Placental Site Trophoblastic Tumor. Curr Treat Options Oncol. 2017 Aug 24;18(10):58. doi: 10.1007/s11864-017-0502-0. PMID: 28840513.
    doi:10.1007/s11864-017-0502-0
    [PMid:28840513]
  17. Zhao J, Xiang Y, Guo L, Wan X, Feng F, Ren T, Reservation of fertility for seventeen patients with placental site trophoblastic tumor. Zhonghua Fu Chan Ke Za Zhi 2014; 49(4): 265-269.
  18. Amy L. Alexander, Anna E. Strohl, Kruti P. Maniar, John R. Lurain. Placental site trophoblastic tumor: Successful treatment of 13 cases. Gynecologic Oncology Reports. 2020 32; 100548, https://doi.org/10.1016/j.gore.2020.100548.
    doi:10.1016/j.gore.2020.100548
    [PMid:32274412]
  19. Aminimoghaddam S, Nezhadisalami F, Anjidani S, Barzin Tond S. Outcome of treatment with EMA/EP (etoposide methotrexate and actinomycin-D/ etoposide and cisplatin) regimen in gestational trophoblastic neoplasia. Med J Islam Repub Iran. 2018 May 3;32:36. doi: 10.14196/mjiri.32.36. PMID: 30159287; PMCID: PMC6108260.
    doi:10.14196/mjiri.32.36
    [PMid:30159287]
آمار
تعداد مشاهده مقاله: 69
تعداد دریافت فایل اصل مقاله: 56