Sato Wataru, Miura Yasuko, Shirasawa Hiromitsu, Kumazawa Yukiyo, Kumagai Jin, Terada Yukihiro
Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan.
Gynecol Minim Invasive Ther. 2017 Apr-Jun;6(2):69-72. doi: 10.1016/j.gmit.2016.11.006. Epub 2017 Jan 4.
Placental site trophoblastic tumor (PSTT) is the rarest subtype of gestational trophoblastic neoplasm. We present a case of PSTT complicating nephrotic syndrome. A 32-year-old woman experienced irregular menstrual bleeding and lower extremity edema 18 months after delivery. She was diagnosed with nephrotic syndrome and exaggerated placental site based on the hysteroscopic biopsy results. During follow-up, transvaginal color Doppler ultrasound showed an enlarged uterus filled with a hypervascular mass. Positron emission tomography-computed tomography showed diffuse accumulation in the entire uterus. The patient was diagnosed with PSTT only after total hysterectomy. Postoperatively, serum β-human chorionic gonadotropin decreased to within the normal range and her nephrotic syndrome resolved. She has remained without evidence of recurrence for 15 months. It is difficult to diagnose PSTT definitively. Most patients with PSTT are of reproductive age, therefore, to maintain fecundity, therapy development is expected.
胎盘部位滋养细胞肿瘤（PSTT）是妊娠滋养细胞肿瘤中最罕见的亚型。我们报告一例PSTT合并肾病综合征的病例。一名32岁女性在分娩后18个月出现月经不规则出血和下肢水肿。根据宫腔镜活检结果，她被诊断为肾病综合征和胎盘部位增生。随访期间，经阴道彩色多普勒超声显示子宫增大，内有高血管团块。正电子发射断层扫描-计算机断层扫描显示整个子宫弥漫性积聚。该患者仅在全子宫切除术后才被诊断为PSTT。术后，血清β-人绒毛膜促性腺激素降至正常范围内，她的肾病综合征得以缓解。她已持续15个月无复发迹象。PSTT的确切诊断很困难。大多数PSTT患者处于育龄期，因此，为了维持生育能力，期待治疗方法的发展。
