1/14. pregnancy with primary tubal placental site trophoblastic tumor--A case report and literature review.Placental site trophoblastic tumor (PSTT) is a rare trophoblastic neoplasm with malignant potential. The diagnosis and prognosis of this rare disease remain difficult. A case of tubal PSTT with the primary manifestation of internal bleeding at 30 weeks' gestation is presented. Emergency exploratory laparotomy and right partial salpingectomy were performed initially. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, and omentectomy were done immediately after cesarean section at 34 weeks' gestation. No further adjuvant therapy was given after surgery. No evidence of tumor recurrence or signs of metastasis were noted during 12 months of follow-up. Heterotopic pregnancy, one with intrauterine normal pregnancy and the other with implanting in the right fallopian tube and placental site trophoblastic tumor transformation, was proposed. To our knowledge, this is the first such case in the English literature.- - - - - - - - - - ranking = 1keywords = trophoblastic neoplasm, neoplasm (Clic here for more details about this article) |
2/14. Prolonged remission of recurrent, metastatic placental site trophoblastic tumor after chemotherapy.BACKGROUND: Placental site trophoblastic tumor (PSTT) is a form of gestational trophoblastic neoplasm that is frequently resistant to chemotherapy. In most cases disease is confined to the uterus and can be cured by curettage or simple hysterectomy. patients with metastases, however, frequently have progression of disease and die despite aggressive multiagent chemotherapy. CASE: A 31-year-old woman was found on review of uterine curettings to have a PSTT. Imaging studies revealed multiple lung lesions, a liver lesion, and an enlarged irregular uterus. hysterectomy and staging surgery revealed a large tumor in the endometrial cavity and multiple metastases. She was treated with etoposide-methotrexate-dactinomycin and cyclophosphamide-vincristine and had a complete clinical remission. Six months later, however, she had a recurrence. She was then treated with six cycles of etoposide-methotrexate-dactinomycin and etoposide-cisplatin. Three years after completion of the second regimen she is without evidence of disease. CONCLUSION: Treatment with multiagent chemotherapy can produce long-term remission, even in patients with recurrent, metastatic PSTT. Addition of platinum may be helpful in patients who have recurred or progressed after treatment with non-platinum-containing regimens.- - - - - - - - - - ranking = 1keywords = trophoblastic neoplasm, neoplasm (Clic here for more details about this article) |
3/14. Malignant placental site trophoblastic tumor: a cytogenetic study using comparative genomic hybridization and chromosome in situ hybridization.BACKGROUND: Placental site trophoblastic tumor (PSTT) is a rare form of gestational trophoblastic neoplasm composed predominantly of intermediate trophoblast. Most showed benign behavior whereas 10-15% of PSTTs were clinically malignant with later recurrence and metastasis. Currently, there are no reliable means to predict clinical outcome, and cytogenetic information is scanty. methods: The clinicopathologic features of two cases of malignant PSTT were analyzed. cytogenetic analysis was performed by comparative genomic hybridization (CGH) and chromosome in situ hybridization (CISH) using frozen tissue and paraffin embedded sections, respectively. RESULTS: Both patients were 32 years old at time of diagnosis. One patient with PSTT presented with menorrhagia, and the other presented with symptoms of missed abortion. Elevated serum human chorionic gonadotropin (HCG) was detected in both patients. Histologic examination showed the typical features of PSTT with high mitotic count (> 5/10 high-power fields). Ovarian and lung metastasis occurred in both patients. Immunohistochemical staining revealed an equal distribution of HCG and human placental lactogen. Cytogenetic studies by CISH showed that karyotypes of these two malignant PSTTs were diploid. Analysis of the tumor tissue by CGH did not show any changes in dna copy numbers. CONCLUSIONS: The authors' study indicated that the two metastasizing PSTTs had balanced diploid karyotype. The malignant behavior of PSTTs may be not related to the dna copy number changes. Such cytogenetic study may be useful in distinguishing metastatic PSTT from choriocarcinoma.- - - - - - - - - - ranking = 1keywords = trophoblastic neoplasm, neoplasm (Clic here for more details about this article) |
4/14. Extrauterine placental site trophoblastic tumour in association with a lithopedion.AIM: We describe an unusual case of extrauterine placental site trophoblastic tumour located in pouch of Douglas in association with a lithopedion. methods AND RESULTS: A 35-year-old female presented with acute abdomen and peritonitis following rectal perforation. The patient gave a history of 5 months amenorrhoea followed by vaginal bleeding 5 years prior to admission. At laparotomy, a lithopedion was found in pouch of Douglas with rectal perforation and peritonitis. The lithopedion was removed, rectal perforation was sutured and a colostomy was performed. The colostomy was closed later and tumour was seen in the colostomy wound as well as attached to the lithopedion removed previously. The patient presented with a repeated episode of rectal perforation and the tumour had spread to colon, small intestine, omentum, mesentery and right ovary. CONCLUSION: A high-grade malignant placental site trophoblastic tumour with aggressive clinical course occurred at an extrauterine site. It complicated calcified abdominal pregnancy and resulted in repeated rectal perforation and peritonitis.- - - - - - - - - - ranking = 108.23653098346keywords = trophoblastic tumour (Clic here for more details about this article) |
5/14. Placental site trophoblastic tumor: p53 gene analysis.BACKGROUND: Placental site trophoblastic tumor (PSTT) is the rarest type of trophoblastic neoplasm. Because of its rarity, the clinical behavior and pathogenesis of PSTT are still unclear. CASE: A 20-year-old woman presented with secondary amenorrhea and irregular vaginal bleeding. Examination of the patient revealed elevated serum hCG and a uterine mass. The specimen obtained by curettage was diagnosed as possible PSTT. The patient was treated with two cycles of EMA/CO, but her uterine mass increased in size. Subsequently, she underwent total abdominal hysterectomy. Microscopic observation revealed a PSTT. To estimate the status of expression of p53 protein and to determine whether p53 gene mutation was present in this PSTT, we carried out immunohistochemical staining for p53 and PCR-SSCP analysis. Immunohistochemical staining for p53 revealed intense nuclear labeling, but no p53 gene mutation was detected in exons 5-8. CONCLUSION: Analysis of the p53 gene may aid understanding of the pathogenesis of PSTT.- - - - - - - - - - ranking = 1keywords = trophoblastic neoplasm, neoplasm (Clic here for more details about this article) |
6/14. Adrenal metastatic placental site trophoblastic tumor. Case report.Placental site trophoblastic tumor is a rare disease. Since its first description in the literature only about 100 cases have been reported. Initially considered a benign pathology, its malignant potential with metastases was later recognized. About 30% of the cases described metastatised, thereby aggravating the prognosis. The therapy is surgical and in cases of metastatised disease has to be supplemented by chemotherapy. A case of placental site trophoblastic tumour with a single metastasis to the left adrenal gland treated with adrenalectomy and chemotherapy is reported.- - - - - - - - - - ranking = 18.039421830576keywords = trophoblastic tumour (Clic here for more details about this article) |
7/14. Placental site trophoblastic tumor in a patient with brain and lung metastases.Placental site trophoblastic tumor is a rare neoplasm that arises from intermediate trophoblasts and shows diversity of biological behaviors, resulting in the absence of consistency in treatment modalities. A case of placental site trophoblastic tumor that extended to the cervix, with primary manifestation of amenorrhea and yellow foul-smelling vaginal discharge, is presented. Total abdominal hysterectomy was performed initially, and serial measurements of human chorionic gonadotropin levels were obtained. She was admitted with metastases to brain and lung 1.5 years after surgery. Combination chemotherapy (etoposide-methotrexate-dactinomycin/cyclophosphamide-vincristine) and radiotherapy were administered. There was no significant response to chemoradiotherapy. Despite changing chemotherapy regimen, she is still alive with progressive disease.- - - - - - - - - - ranking = 2.7031843819214E-6keywords = neoplasm (Clic here for more details about this article) |
8/14. Placental site trophoblastic tumor.Placental site trophoblastic tumor is very rare. It is a gestational trophoblastic neoplasm which follows normal or molar pregnancy. It is usually confined to uterus & 15-20% behave in a malignant fashion. Clinically patients present with abnormal excessive bleeding or amenorrhoea. Though several trophoblastic lesions & tumors enter in the differential diagnosis, microscopically the diagnosis is usually straightforward in hysterectomy specimens. hysterectomy is the treatment with or without chemotherapy. Progress after surgery should be monitored by placental lactogenic hormone.- - - - - - - - - - ranking = 1keywords = trophoblastic neoplasm, neoplasm (Clic here for more details about this article) |
9/14. Placental site trophoblastic tumour--a case report.Placental site trophoblastic tumour is a rare form of gestational trophoblastic disease, which seldom metastasizes. It is chemoresistant though has an excellent prognosis after complete resection of the tumour. Its characterization is thus important for treatment and further management. We present an unusual case who presented with ascites of non-neoplastic origin and was found to have metastases to the lymph node.- - - - - - - - - - ranking = 90.197109152881keywords = trophoblastic tumour (Clic here for more details about this article) |
10/14. Emergency surgery in gestational trophoblastic tumours.The prognosis in patients with placental tumours, invasive mole or choriocarcinoma, is excellent. Chemotherapy offers, in the majority of cases, complete cure with preservation of fertility. However, surgery still plays a role in this group of diseases. Elective surgery aiming at curing the patient plays a minor but definitive role in selected patients. This study discusses emergency surgical procedures. In 92 patients treated because of gestational trophoblastic neoplasia at one institution 10 patients (11%) were subjected to invasive surgery, for the most part because of life threatening haemorrhage.- - - - - - - - - - ranking = 72.157687322305keywords = trophoblastic tumour (Clic here for more details about this article) |
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