Yordanov Angel, Strateva Diana, Kostov Stoyan, Kornovski Yavor, Slavchev Stanislav, Ivanova Yonka, Nikolova Margarita
Department of Gynaecological Oncology, Medical University Pleven, Pleven, Bulgaria.
Department of Gynaecology, Medical University "Prof. Dr. Paraskev Stoyanov", Varna, Bulgaria.
Prz Menopauzalny. 2022 Jun;21(2):142-147. doi: 10.5114/pm.2022.116502. Epub 2022 May 30.
Gestational trophoblastic disease (GTD) covers a range of proliferative disorders from non-neoplastic hydatid moles to malignant neoplastic conditions such as choriocarcinoma. The incidence of these diseases is low and often challenging to diagnose. Placental site trophoblastic tumour (PSTT) is the rarest form of GTD, accounting for up to 3% of all cases. We present a case of a 35-year-old patient diagnosed with PSTT mimicking an intramural pregnancy. Placental site trophoblastic tumour occurred after pregnancy, which ended as a blighted ovum. β-hCG was not very high, and the patient had no complaints. The diagnosis was made after resection of formation which was accepted for intramural pregnancy. To our knowledge, this is the first such case described in the literature. A hysterectomy performed later confirmed the absence of a residual tumour after conservative intervention. The lack of distant metastases, confirmed by positron emission tomography-computed tomography scan, allowed for only hysterectomy with bilateral salpingo-oophorectomy to be performed. The patient was classified as low risk according to the World Health Organization (WHO) scoring system. Placental site trophoblastic tumour is a rare malignant tumour (despite its WHO coding) from the group of GTDs. It is not presented with a classic clinical picture, and its clinical diagnosis is challenging. However, clinicians should consider it in the case of unclear events after any type of pregnancy.
妊娠滋养细胞疾病（GTD）涵盖了一系列从非肿瘤性葡萄胎到恶性肿瘤性疾病（如绒毛膜癌）的增殖性疾病。这些疾病的发病率较低，诊断往往具有挑战性。胎盘部位滋养细胞肿瘤（PSTT）是GTD中最罕见的形式，占所有病例的比例高达3%。我们报告一例35岁患者，诊断为PSTT，临床表现酷似子宫肌壁间妊娠。胎盘部位滋养细胞肿瘤发生于一次以胚胎停育告终的妊娠之后。β-hCG水平不是很高，患者也没有不适主诉。在切除被误诊为子宫肌壁间妊娠的组织后才得以确诊。据我们所知，这是文献中描述的首例此类病例。后来实施的子宫切除术证实了保守干预后无残留肿瘤。正电子发射断层扫描-计算机断层扫描（PET-CT）检查证实无远处转移，因此仅实施了子宫切除术及双侧输卵管卵巢切除术。根据世界卫生组织（WHO）评分系统，该患者被归类为低风险。胎盘部位滋养细胞肿瘤是GTD组中一种罕见的恶性肿瘤（尽管其WHO编码如此）。它没有典型的临床表现，临床诊断具有挑战性。然而，对于任何类型妊娠后出现不明情况的病例，临床医生都应考虑到这种疾病。
