Radiology, Hospital do Divino Espirito Santo de Ponta Delgada EPE, Ponta Delgada, Portugal
Pathology, Instituto Português de Oncologia de Lisboa Francisco Gentil EPE, Lisboa, Portugal.
BMJ Case Rep. 2020 Oct 10;13(10):e235756. doi: 10.1136/bcr-2020-235756.
Placental site trophoblastic tumour (PSTT) is a very rare form of gestational trophoblastic disease that grows slowly, secretes low levels of beta-subunit of human chorionic gonadotropin (β-hCG), presents late-onset metastatic potential and is resistant to several chemotherapy regimens. Here, we report a case of PSTT in a 36-year-old woman who presented with amenorrhea and persistently elevated serum level of β-hCG after a miscarriage. Transvaginal ultrasound revealed a hypovascular ill-defined solid lesion of the uterine fundus and MRI showed a tumour infiltrating the external myometrium with discrete early enhancement and signal restriction on diffusion-weighted imaging. PSTT was suspected, and after endometrial biopsy by hysteroscopy and posterior hysterectomy, microscopic examination allowed the final diagnosis. The level of β-hCG dropped significantly in about a month after surgical treatment. Due to the rarity of PSTT, reporting new cases is crucial to improve the diagnosis and managing of these patients.
胎盘部位滋养细胞肿瘤（PSTT）是一种非常罕见的妊娠滋养细胞疾病，生长缓慢，人绒毛膜促性腺激素β亚单位（β-hCG）分泌水平低，具有晚期转移性潜能，且对几种化疗方案具有耐药性。在这里，我们报告了一例 36 岁女性的 PSTT 病例，该患者因流产后闭经和血清β-hCG 持续升高而就诊。经阴道超声显示子宫底部低血流不规则实性肿块，MRI 显示肿瘤浸润子宫外肌层，早期呈离散性增强，弥散加权成像上信号受限。怀疑为 PSTT，行宫腔镜下子宫内膜活检和子宫后切除术，显微镜检查可明确诊断。β-hCG 水平在手术后约一个月内显著下降。由于 PSTT 罕见，报告新病例对于改善这些患者的诊断和治疗至关重要。
