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酷似胎盘部位滋养细胞肿瘤的胎盘植入:一例罕见病例报告。

Placenta increta mimicking placental site trophoblastic tumor: A rare case report.

作者信息

Aminimoghaddam Soheila, Sarchami Niloufar, Ghaderi Elahe

机构信息

Department of Obstetrics and Gynecology, Iran University of Medical Sciences, Tehran, Iran.

Department of Obstetrics and Gynecology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Int J Surg Case Rep. 2025 Jan;126:110651. doi: 10.1016/j.ijscr.2024.110651. Epub 2024 Nov 26.

DOI:10.1016/j.ijscr.2024.110651
PMID:39626429
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11652924/
Abstract

INTRODUCTION AND IMPORTANCE

Placenta increta (PI) can mimic a rare malignant tumor called Placental-site trophoblastic tumor (PSTT) with similar laboratory and clinical findings. Histological findings can help correctly diagnose PI from rare malignant tumors of PSTT.

CASE PRESENTATION

According to our knowledge, only one case of PI has been reported in the literature, each of which had different characteristics, and various aspects of this lesion still need to be clarified. We reported a case of PI mimicking PSTT in a 37-year-old female. The uniqueness of the present case was its huge size and no history of abortion compared to the PI reported in the previous study.

CLINICAL DISCUSSION

Our patients' ultrasound and immunohistochemical characteristics were similar to the case reported in the study. After the complete hysterectomy, the patient's bleeding stopped completely, and the patient remained disease-free during the two-year follow-up.

CONCLUSION

PI can mimic a rare malignant tumor called PSTT with similar laboratory and clinical findings (Severe bleeding). The differential diagnosis of retained placenta in patients with extensive bleeding, either after vaginal delivery or after Cesarean section or abortion, should be carefully considered from PSTT. Both diseases (PSTT and PI) are treated with hysterectomy. Histological findings can help correctly diagnose PI from rare malignant tumors of PSTT.

摘要

引言与重要性

胎盘植入(PI)可表现出与一种罕见恶性肿瘤——胎盘部位滋养细胞肿瘤(PSTT)相似的实验室及临床特征。组织学检查结果有助于从PSTT这种罕见恶性肿瘤中正确诊断出PI。

病例报告

据我们所知,文献中仅报道过一例PI,每例都有不同特点,且该病变的各个方面仍有待阐明。我们报告了一例37岁女性患者,其PI表现类似PSTT。与先前研究报道的PI相比,本病例的独特之处在于其体积巨大且无流产史。

临床讨论

我们患者的超声及免疫组化特征与该研究报道的病例相似。全子宫切除术后,患者出血完全停止,在两年随访期间无疾病复发。

结论

PI可表现出与罕见恶性肿瘤PSTT相似的实验室及临床特征(严重出血)。对于阴道分娩、剖宫产或流产后出现大量出血的患者,鉴别诊断胎盘残留时应仔细考虑PSTT。两种疾病(PSTT和PI)均采用子宫切除术治疗。组织学检查结果有助于从PSTT这种罕见恶性肿瘤中正确诊断出PI。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/533a/11652924/00f8e498c8df/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/533a/11652924/a9d7f9e3fd11/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/533a/11652924/00f8e498c8df/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/533a/11652924/a9d7f9e3fd11/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/533a/11652924/00f8e498c8df/gr2.jpg

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本文引用的文献

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Treatment of Immature Teratoma Associated with Ovarian Endometrioma: A Case Report.卵巢子宫内膜异位症相关未成熟畸胎瘤的治疗:一例报告
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The SCARE 2023 guideline: updating consensus Surgical CAse REport (SCARE) guidelines.SCARE 2023 指南:更新共识外科病例报告(SCARE)指南。
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A rare case of placenta accreta after a first-trimester abortion.孕早期流产后发生胎盘植入的罕见病例。
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Placenta increta mimicking placental site trophoblastic tumor.胎盘植入酷似胎盘部位滋养细胞肿瘤。
Int J Gynecol Cancer. 2021 Nov;31(11):1481-1485. doi: 10.1136/ijgc-2021-002988.
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Postpartum unscarred uterine rupture caused by placenta accreta: A case report and literature review.胎盘植入所致产后未瘢痕子宫破裂:一例报告及文献复习
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Retrospective study of placenta accreta, placenta increta and placenta percreta in Peripartum hysterectomy specimens.围产期子宫切除标本中胎盘植入、穿透性胎盘植入和完全性胎盘植入的回顾性研究。
Indian J Pathol Microbiol. 2020 Feb;63(Supplement):S87-S90. doi: 10.4103/IJPM.IJPM_229_19.
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Management of patients with placenta accreta spectrum disorders who underwent pregnancy terminations in the second trimester: A retrospective study.中孕期终止妊娠的胎盘植入谱系疾病患者的管理:一项回顾性研究。
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First-trimester abortion complicated with placenta accreta: A systematic review.孕早期流产合并胎盘植入:一项系统综述。
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