title: Diagnosis and management of a rare case with placental site trophoblastic tumor.
abstract: OBJECTIVE
  Placental site trophoblastic tumor (PSTT) is rare and is characterized by a slow growth. The objective of this report is to present a case of PSTT associated with irregular vaginal spotting that occurred 1 year after normal vaginal delivery.
  
  
  METHODS
  This report provides interesting ultrasound, hysteroscopy, and histology findings of PSTT. It is difficult to make a clinical diagnosis of PSTT at an early stage. Without the use of immunohistochemical analysis, PSTT may evade histological detection. An operative hysteroscopy using electrocauterization reduces active bleeding during the removal of PSTT with markedly engorged tumor vessels.
  
  
  CONCLUSIONS
  Transvaginal sonography using color Doppler imaging plays a vital role in identifying residual PSTT with microscopic infiltration to the myometrium and a negative serum β-human chorionic gonadotropin level.
authors.affiliation: Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. Electronic address: fncho@isca.vghks.gov.tw.
authors.forename: Fu-Nan
authors.initials: FN
authors.lastname: Cho
authors.affiliation: Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: San-Nung
authors.initials: SN
authors.lastname: Chen
authors.affiliation: Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: Yu-Hsiang
authors.initials: YH
authors.lastname: Chang
authors.affiliation: Department of Applied Chemistry, National University of Kaohsiung, Kaohsiung, Taiwan.
authors.forename: James R
authors.initials: JR
authors.lastname: Carey
mesh_terms: D000328:Adult; D001706:Biopsy; D003937:Diagnosis, Differential; D019468:Disease Management; D019160:Endosonography; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D007231:Infant, Newborn; D049268:Positron-Emission Tomography; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic; D018245:Trophoblastic Tumor, Placental Site / Q000175:diagnosis* / Q000601:surgery; D018615:Ultrasonography, Doppler, Color; D016216:Ultrasonography, Prenatal / Q000379:methods*; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000601:surgery; D014621:Vagina
keywords: color Doppler; histology; human chorionic gonadotropin; placental site trophoblastic tumor; transvaginal sonography