Patacchiola F, Di Stefano L, Di Febbo G, D'Alfonso A, Di Fonso A, Carta G
Eur J Gynaecol Oncol. 2014;35(1):87-90.
Placental site trophoblastic tumor (PSTT) is the least common form of gestational trophoblastic disease (GTD), and is biologically different from other forms of GTD. There is a wide clinical spectrum of presentation and behavior ranging from a benign condition to an aggressive disease with a fatal outcome. The authors document a case of PSTT on an endometrial polyp. A 51-year-old woman had abnormal vaginal bleeding for the duration of two months. Her past history included a vaginal delivery in 1998. Her physical examination was normal. Tumor markers were at normal levels. Serum beta- human chorionic gonadotropin (hCG) level was 19 mIU/ml and human placental lactogen (hPL) level was in the normal range. The patient underwent an operative hysteroscopy. On examination the uterine cavity appeared to be occupied by a pedunculated polypoid neoformation measuring about 2.5 cm in diameter which was removed and later determined to be a PSTT. There were occasional mitotic figures (0-1/10 high power field). The patient underwent hysterectomy and bilateral salpingo-oophorectomy. The patient has no evidence of disease six months after surgery. The authors conclude that a high mitotic count and atypical undifferentiated pathological features are significant poor prognostic factors for survival in PSTT. Hysterectomy represents the gold standard of treatment in all cases of disease confined to the uterus.
胎盘部位滋养细胞肿瘤（PSTT）是妊娠滋养细胞疾病（GTD）中最不常见的类型，在生物学上与其他类型的GTD不同。其临床表现和行为范围广泛，从良性状态到具有致命结局的侵袭性疾病。作者记录了一例发生在子宫内膜息肉上的PSTT病例。一名51岁女性出现了两个月的异常阴道出血。她的既往史包括1998年顺产。体格检查正常。肿瘤标志物水平正常。血清β-人绒毛膜促性腺激素（hCG）水平为19 mIU/ml，人胎盘催乳素（hPL）水平在正常范围内。患者接受了宫腔镜手术。检查时，子宫腔内似乎被一个直径约2.5 cm的带蒂息肉样新生物占据，该新生物被切除，后来确定为PSTT。偶见核分裂象（0 - 1/10高倍视野）。患者接受了子宫切除术和双侧输卵管卵巢切除术。术后六个月患者无疾病证据。作者得出结论，高核分裂计数和非典型未分化病理特征是PSTT患者生存的重要不良预后因素。子宫切除术是所有局限于子宫的疾病病例的治疗金标准。
