Bajka M, Köchli O R, Schmidt D, Robbiani M, Stallmach T, Haller U
Departement Frauenheilkunde, Universitätsspital Zürich, Schweiz.
Gynakol Geburtshilfliche Rundsch. 1995;35(1):38-41. doi: 10.1159/000272469.
The case of a placental-site trophoblastic tumor (PSTT) is described. Transvaginal sonography revealed a vascularized tumor mass with a deep invasion of the myometrium, partly with echogenic, solid parts and partly multiple echo-free cystic lesions. The maximum size of an echo-free cystic lesion was 4.4 cm. Doppler exploration indicated the presence of blood flow in all these cystic lesions. Distinctly abnormal low flow indices were prominent in the whole tumor area. According to the clinical results and the slightly positive levels of human chorionic beta-gonadotropin (100-1,000 IU/l postpartum), this tumor was classified as malignant trophoblastic disease, most likely PSTT. The authors conclude that, in the case of a patient with suspected trophoblastic disease and in view of the sonographic findings, PSTT may be a valid differential diagnosis, particularly if larger cystic lesions of more than 3 cm in diameter are found in the tumor bed together with evident blood flow at a low vascular resistance.
本文描述了一例胎盘部位滋养细胞肿瘤（PSTT）。经阴道超声检查发现一个血管化的肿瘤肿块，肌层有深度浸润，部分为回声增强的实性部分，部分为多个无回声囊性病变。无回声囊性病变的最大尺寸为4.4厘米。多普勒检查表明所有这些囊性病变中均有血流。整个肿瘤区域明显异常的低血流指数很突出。根据临床结果和人绒毛膜促性腺激素β亚基水平略呈阳性（产后100 - 1000 IU/L），该肿瘤被归类为恶性滋养细胞疾病，很可能是PSTT。作者得出结论，对于疑似滋养细胞疾病的患者，鉴于超声检查结果，PSTT可能是一个有效的鉴别诊断，特别是如果在肿瘤床发现直径大于3厘米的较大囊性病变且伴有明显的低血管阻力血流。
