A rare presentation of a patient with placental site trophoblastic tumor

Document Type : Case report

Authors

1 Associate professor, Department of Obstetrics and Gynecology, Women's Health, Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Resident, Department of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Resident fellowship of Gynecology Oncology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Resident, Department of General Surgery, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Placental site trophoblastic tumor (PSTT) is a subgroup of gestational trophoblastic tumor and its incidence is very rare and 1 in 10000. The origin of this tumor is placental site and its symptoms are vaginal bleeding, metastatic symptoms, and …. Here, a rare presentation of PSTT is reported.
Case Report: A 24-years old woman, P1L1 with history of vaginal delivery one year ago and abnormal vaginal bleeding from 6 months ago had referred. Pelvic sonography reported a fibroma sized 29×45 mm as a myoma in the uterus. Due to abnormal vaginal bleeding which was refractory to medical therapy, myomectomy was done. The pathologic diagnosis was leiomyosarcoma. Then, the patient was referred to Ghaem Hospital Tumor Clinic. The diagnosis of the second pathology review of the same specimen was placental site trophoblastic tumor. Serum hCG level was 119 milliunit in milliliter. The patient had no desire to preserve fertility, so hysterectomy was done. One week after surgery, hCG level was normal and now after 8 months, the patient is disease free.
Conclusion: Placental site trophoblastic tumor is a rare tumor which should be suspected in a patient who presents with term pregnancy and abnormal vaginal bleeding and a myoma in sonography.

Keywords

References

  1. Soheili F, Alizadeh S, Hassani M, Bastami P. The pathologic assessment of breast masses, before and after menopause. Iran Obstet Gynecol Infertil 2013; 16(68):21-7. (Persian).
  2. Karimi A, Moradi Z, Sayehmiri K, Delpisheh A, Sayehmiri F. Investigation of 1 to 10-year survival of breast cancer in Iranian women: a systematic review and meta-analysis. Iran Obstet Gynecol Infertil 2016; 19(22):17-25. (Persian).
  3. Adjogatse D, Thanopoulou E, Okines A, Thillai K, Tasker F, Johnston SR, et al. Febrile neutropaenia and chemotherapy discontinuation in women aged 70 years or older receiving adjuvant chemotherapy for early breast cancer. Clin Oncol 2014; 26(11):692-6.
  4. Jensen JD, Cold S, Nielsen MH, Jylling AM, Søe KL, Larsen LB, et al. Trends in breast cancer in the elderly in Denmark, 1980-2012. Acta Oncol 2016; 55(Suppl 1):59-64.
  5. Extermann M, Balducci L, Lyman GH. What threshold for adjuvant therapy in older breast cancer patients? J Clin Oncol 2000; 18(8):1709-17.
  6. Litvak DA, Arora R. Treatment of elderly breast cancer patients in a community hospital setting. Arch Surg 2006; 141(10):985-90.
  7. de Glas NA, Kiderlen M, de Craen AJ, Hamaker ME, Portielje JE, van de Velde CJ, et al. Assessing treatment effects in older breast cancer patients: systematic review of observational research methods. Cancer Treat Rev 2015; 41(3):254-61.
  8. Benevento R, Santoriello A, Gambardella A, Mocerino C, Perna G, Gambardella C, et al. The role of sentinel node biopsy (SNB) in elderly breast cancer patients. BMC Geriat 2010; 10(1):A3.
  9. Valassiadou K, Morgan DA, Robertson JF, Pinder SE, Cheung KL. Successful management of elderly breast cancer patients treated without radiotherapy. World J Surg Oncol 2007; 5:62.
  10. Li JJ, Yu KD, Di GH, Shao ZM. Clinicopathological features and treatment sensitivity of elderly Chinese breast cancer patients. Oncol Lett 2010; 1(6):1037-43.
  11. Rocco N, Iannone L, Rispoli C, De Vito D, Accurso A. Early breast cancer in elderly women: surgery or primary endocrine therapy? BMC Geriat 2010; 10(1):A31.
  12. Malik MK, Tartter PI, Belfer R. Undertreated breast cancer in the elderly. J Cancer Epidemiol 2013; 2013:893104.
  13. Dimitrakopoulos F, Kottorou A, Antonacopoulou AG, Makatsoris T, Kalofonos HP. Early-stage breast cancer in the elderly: confronting an old clinical problem. J Breast Cancer 2015; 18(3):207-17.
  14. Mousavi SM, Montazeri A, Mohagheghi MA, Jarrahi AM, Harirchi I, Najafi M, et al. Breast cancer in Iran: an epidemiological review. Breast J 2007; 13(4):383-91.
  15. Villari SA, Famà F, Scarfò P, Pollicino A, Florio MG. Tailored surgery in elderly patients with breast cancer: our experience. BMC Geriat 2010; 10(Suppl 1):A38.
  16. Wang H, Singh AP, Luce SA, Go AR. Breast cancer treatment practices in elderly women in a community hospital. Int J Breast Cancer 2011; 2011:467906.

Angarita FA, Chesney T, Elser C, Mulligan AM, McCready DR, Escallon J. Treatment patterns of elderly breast cancer patients at two Canadian cancer centers. Eur J Surg Oncol 2015; 41(5):625-34.

The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 19, Issue 33
November 2016
Pages 23-27

Files

Share

How to cite

Statistics