Niknejadi Maryam, Ahmadi Firoozeh, Akhbari Farnaz
Department of Reproductive Imaging , Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
Iran J Radiol. 2016 Apr 16;13(2):e18480. doi: 10.5812/iranjradiol.18480. eCollection 2016 Apr.
Placental site trophoblastic tumor (PSTT) is a very rare variant of gestational trophoblastic tumor. It can occur after normal termination of pregnancy or spontaneous abortion and ectopic or molar pregnancy. There is a wide range of clinical manifestations from a benign condition to an aggressive disease with fatal outcome. One of the most important characteristics of PSTT, unlike other forms of gestational trophoblastic diseases (GTD) is the presence of low beta-subunit of human chorionic gonadotropin (β-hCG) levels because it is a neoplastic proliferation of intermediate trophoblastic cells. However, human placental lactogen (hPL) is increased on histologic section and in the serum of patients too. We present a case of PSTT and discuss the differential diagnosis in order to further familiarize physicians with the diagnosis and treatment of this disease. It has a varied clinical spectrum and usually presents with irregular vaginal bleeding or amenorrhea. Diagnosis is confirmed by dilatation and curettage (D and C) and hysterectomy. Because chemotherapy is not effective, surgery is the cornerstone of treatment. This case is presented because it is a rare neoplasm with different treatments and it should be differentiated from molar pregnancy.
胎盘部位滋养细胞肿瘤（PSTT）是妊娠滋养细胞肿瘤中一种非常罕见的类型。它可发生于正常妊娠终止、自然流产、异位妊娠或葡萄胎妊娠之后。其临床表现范围广泛，从良性状态到具有致命结局的侵袭性疾病。与其他形式的妊娠滋养细胞疾病（GTD）不同，PSTT最重要的特征之一是血清人绒毛膜促性腺激素（β-hCG）β亚基水平较低，因为它是中间型滋养细胞的肿瘤性增殖。然而，在组织切片以及患者血清中，人胎盘生乳素（hPL）水平也会升高。我们报告一例PSTT病例，并讨论其鉴别诊断，以便让医生进一步熟悉这种疾病的诊断和治疗。它具有多样的临床谱，通常表现为不规则阴道出血或闭经。诊断通过刮宫术（D和C）及子宫切除术来确诊。由于化疗无效，手术是治疗的基石。呈现该病例是因为它是一种具有不同治疗方法的罕见肿瘤，且应与葡萄胎妊娠相鉴别。
