Placental-site trophoblastic tumors: a case of resistant pulmonary metastasis.
Background A 52-year-old woman whose last known pregnancy was 12 years before presentation was diagnosed with mixed trophoblastic tumor that included placental-site trophoblastic tumor, epithelioid trophoblastic tumor, and focal choriocarcinoma. There was no clear evidence of metastatic disease on initial evaluation. Investigations Histopathology, laboratory tests, immunohistochemistry, chest X-ray, CT scan of the chest, abdomen, and pelvis, fine-needle aspiration biopsy, PET-CT scan.Diagnosis Metastatic chemoresistant placental-site trophoblastic tumor positive for EGFR, VEGF receptor, and platelet-derived growth factor receptor. Management Abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic radiation, etoposide, methotrexate, actinomycin D/cyclophosphamide and vincristine chemotherapy, left thoracotomy with wedge resection, taxol, etoposide, cisplatin therapy, right thoracotomy with wedge resection.
Cole
Michael E
ME
Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, B-1100 Medical Center North, Nashville, TN 37232-2519, USA. michael.cole@vanderbilt.edu
Broaddus
Russell
R
Thaker
Premal
P
Landen
Charles
C
Freedman
Ralph S
RS
D003131:Combined Modality Therapy; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D008875:Middle Aged; D018198:Mixed Tumor, Malignant / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D011247:Pregnancy; D018245:Trophoblastic Tumor, Placental Site / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D014594:Uterine Neoplasms / Q000473:pathology* / Q000628:therapy