title: Placental site trophoblastic tumor: a case report and review of the literature.
abstract: We present a case of a gravida 1 para 1 woman, who presented with an 11-month history of amenorrhea after cesarean delivery. The patient was taking birth control pills at the time of presentation. She was observed with a slight elevation of serum β-hCG level, an enlarged heterogeneous uterus and hematometra. A biopsy was performed, and the patient was diagnosed with placental site trophoblastic tumor; the patient then underwent surgery. Placental site trophoblastic tumor is the rarest form of gestational trophoblastic disease, derived from intermediate trophoblast cells. It does not have a pathognomonic appearance; therefore, correlation with medical history, as well as results of laboratory tests and pathological analysis is mandatory. It is a relatively chemoresistant tumor, posing considerable therapeutic challenges; patients with localized disease are managed with surgery and those with metastatic disease require additional chemotherapy. Herein, we review the main features of this entity and top differential diagnosis, as the rarity of this tumor is associated with imaging and pathological pitfalls, reinforcing the need for further experience in this field.
authors.affiliation: Department of Radiology, Hospital de Santo António dos Capuchos, CHLC, Lisboa, Portugal.
authors.forename: Rita
authors.initials: R
authors.lastname: Lucas
authors.affiliation: Department of Radiology, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal.
authors.forename: Teresa Margarida
authors.initials: TM
authors.lastname: Cunha
authors.affiliation: Department of Pathology, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal.
authors.forename: Filipa Batista
authors.initials: FB
authors.lastname: Santos
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D016896:Treatment Outcome; D018245:Trophoblastic Tumor, Placental Site / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D014463:Ultrasonography; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D014599:Uterus / Q000000981:diagnostic imaging / Q000473:pathology
keywords: Gestational trophoblastic disease; Magnetic resonance; Placental site trophoblastic tumor; Ultrasound; Uterus