Treatment of placental site trophoblastic tumor with hysterotomy and uterine reconstruction

Gary S Leiserowitz, Maurice J. Webb

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Background: Placental site trophoblastic tumor is an unusual variant of gestational trophoblastic neoplasia that is usually confined to the uterus, although 10% of patients have metastases. Because this tumor occurs in women of reproductive age, preservation of fertility may be relevant. Therefore, local excision of placental site trophoblastic tumor by hysterotomy may have a place in management. Case: A 25-year-old woman, gravida 1, para 1, presented with irregular bleeding. Uterine curettage revealed intermediate trophoblasts that on immunostaining were positive for hCG and human placental lactogen, consistent with placental site trophoblastic tumor. Endovaginal ultrasonography and magnetic resonance imaging demonstrated tumor localized to the anterior fundal myometrium. The patient underwent local excision of the tumor by hysterotomy followed by uterine reconstruction. Pathologic examination confirmed that the surgical margins were free of tumor. The patient has had no recurrence. Two subsequent pregnancies resulted in two spontaneous abortions. A third pregnancy was carried to term. The patient was delivered by cesarean because of the hysterotomy. The hysterotomy scar was intact at cesarean. Conclusion: Hysterectomy has been recommended by most authors for treatment for placental site trophoblastic tumor. In some patients with localized placental site trophoblastic tumor who desire preservation of fertility, more conservative surgical therapy may be considered.

Original languageEnglish (US)
Pages (from-to)696-699
Number of pages4
JournalObstetrics and Gynecology
Volume88
Issue number4 II SUPPL.
DOIs
StatePublished - Oct 1996

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Placental Site Trophoblastic Tumor
Hysterotomy
Fertility Preservation
Neoplasms
Gestational Trophoblastic Disease
Placental Lactogen
Therapeutics
Pregnancy
Curettage
Myometrium
Trophoblasts
Spontaneous Abortion
Hysterectomy
Uterus
Cicatrix
Ultrasonography
Magnetic Resonance Imaging
Hemorrhage
Neoplasm Metastasis
Recurrence

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Treatment of placental site trophoblastic tumor with hysterotomy and uterine reconstruction. / Leiserowitz, Gary S; Webb, Maurice J.

In: Obstetrics and Gynecology, Vol. 88, No. 4 II SUPPL., 10.1996, p. 696-699.

Research output: Contribution to journalArticle

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