Ayas Selcuk, Gurbuz Ayse, Karateke Ates, Cetiner Handan
Department of Gynecology and Obstetrics, Zeynep Kamil Maternity and Child Research and Training Hospital, Istanbul, Turkey.
Med Oncol. 2009;26(1):96-100. doi: 10.1007/s12032-008-9076-9. Epub 2008 May 28.
Placental site trophoblastic tumor is a rare form of gestational trophoblastic disease, derived from invasive implantation site (intermediate) trophoblastic cells. It is frequently resistant to chemotherapy. Patients with metastases, however, frequently have progressive disease and die despite surgery and multiagent chemotherapy. In this case, a 24-year-old woman was referred because of intermittent vaginal bleeding episodes for 5 months following delivery. Multiple metastases in lungs, liver, kidneys, breast, pancreas, and adrenal and thyroid glands were detected. Combination therapy including surgery and multiagent chemotherapy was planned. Hysterectomy and pelvic lymph node dissection were performed. All metastatic lesions disappeared with EMA-CO treatment. However four courses of BEP regimen, salvage therapy, was performed for plateauing hCG level. Surgery and multiagent chemotherapy seem mainstay of treatment of cases having multiple metastases of PSTTs.
胎盘部位滋养细胞肿瘤是妊娠滋养细胞疾病的一种罕见形式，起源于侵袭性着床部位（中间型）滋养细胞。它常常对化疗耐药。然而，有转移的患者尽管接受了手术和多药联合化疗，病情仍常呈进行性发展并导致死亡。在本病例中，一名24岁女性因产后5个月间歇性阴道出血就诊。检测发现其肺部、肝脏、肾脏、乳腺、胰腺以及肾上腺和甲状腺有多处转移。计划采用包括手术和多药联合化疗的综合治疗。实施了子宫切除术和盆腔淋巴结清扫术。经EMA - CO方案治疗后所有转移病灶均消失。然而，由于血hCG水平停滞不前，又进行了四个疗程的BEP方案挽救治疗。手术和多药联合化疗似乎是胎盘部位滋养细胞肿瘤发生多处转移病例的主要治疗方法。
