Placental site trophoblastic tumor with multiple metastases and complete response to salvage BEP regimen: a case report and review of the literature.
Placental site trophoblastic tumor is a rare form of gestational trophoblastic disease, derived from invasive implantation site (intermediate) trophoblastic cells. It is frequently resistant to chemotherapy. Patients with metastases, however, frequently have progressive disease and die despite surgery and multiagent chemotherapy. In this case, a 24-year-old woman was referred because of intermittent vaginal bleeding episodes for 5 months following delivery. Multiple metastases in lungs, liver, kidneys, breast, pancreas, and adrenal and thyroid glands were detected. Combination therapy including surgery and multiagent chemotherapy was planned. Hysterectomy and pelvic lymph node dissection were performed. All metastatic lesions disappeared with EMA-CO treatment. However four courses of BEP regimen, salvage therapy, was performed for plateauing hCG level. Surgery and multiagent chemotherapy seem mainstay of treatment of cases having multiple metastases of PSTTs.
Department of Gynecology and Obstetrics, Zeynep Kamil Maternity and Child Research and Training Hospital, Istanbul, Turkey. sayas55@hotmail.com
Selcuk
S
Ayas
Ayse
A
Gurbuz
Ates
A
Karateke
Handan
H
Cetiner
D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000097:blood / Q000556:secondary; D006063:Chorionic Gonadotropin / Q000097:blood; D002945:Cisplatin / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D003609:Dactinomycin / Q000627:therapeutic use; D004067:Digestive System Neoplasms / Q000097:blood / Q000556:secondary; D004701:Endocrine Gland Neoplasms / Q000097:blood / Q000556:secondary; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007680:Kidney Neoplasms / Q000097:blood / Q000556:secondary; D008175:Lung Neoplasms / Q000097:blood / Q000556:secondary; D008197:Lymph Node Excision; D008727:Methotrexate / Q000627:therapeutic use; D010388:Pelvis / Q000601:surgery; D011247:Pregnancy; D018245:Trophoblastic Tumor, Placental Site / Q000097:blood / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy*; D014592:Uterine Hemorrhage; D014594:Uterine Neoplasms / Q000097:blood / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy*; D014750:Vincristine / Q000627:therapeutic use; D055815:Young Adult
D000972:Antineoplastic Agents, Phytogenic; D006063:Chorionic Gonadotropin; D001761:Bleomycin; D003609:Dactinomycin; D014750:Vincristine; D005047:Etoposide; D003520:Cyclophosphamide; D002945:Cisplatin; D008727:Methotrexate