A Review on the Pathogenesis and Clinical Management of Placental Site Trophoblastic Tumors

Abstract

Placental site trophoblastic tumor (PSTT) is a rare type of gestational trophoblastic disease originating from the intermediate trophoblast. Compared with hydatidiform mole, invasive hydatidiform mole and choriocarcinoma, the diagnosis of PSTT is more complicated and lacks specific and sensitive tumor markers. Most PSTT patients demonstrate malignant potential, and the primary treatment of PSTT is hysterectomy. However, metastasis occasionally occurs and even causes death in a small number of PSTT patients. Most PSTT patients are young women hence fertility preservation is an important consideration. The major obstacle for PSTT patient prognosis is chemotherapy resistance. However, the current understanding of the pathogenesis of PSTT and clinical treatment remains elusive. In this review, we summarized the research progress of PSTT in recent years from three aspects: mechanism, clinical presentation, and treatment and prognosis. Well-conducted multi-center studies with sufficient sample sizes are of great importance to better examine the pathological progress and evaluate the prognosis of PSTT patients, so as to develop prevention and early detection programs, as well as novel treatment strategies, and finally improve prognosis for PSTT patients.

<p>Her2-Targeted Multifunctional Nano-Theranostic Platform Mediates Tumor Microenvironment Remodeling and Immune Activation for Breast Cancer Treatment</p>

“…19 Traditional nanomedicine cannot accumulate actively around the tumor through blood vessels, and only a small fraction of nanoparticles accumulate in the tumor. 14,15 Above all, low treatment efficiency is bound to drug resistance of tumor cells, 43,44 thus leading to poorer prognosis of cancer patients. In this study, we developed Her2-DOX -SPIOs@PLGA@Au nanoparticles for breast cancer treatment.…”

Sequential metastasis to the liver and pancreas 4 years after gestational trophoblastic neoplasia: a case report

“… 4 PSTT is relatively resistant to chemotherapy compared with other GTNs. 4 The treatment recommended by the National Comprehensive Cancer Network was surgery and chemotherapy with a platinum/etoposide-containing regimen, such as EMA/etoposide +cisplatin (EP) or other regimens such as TP/paclitaxel + etoposide (TE), bleomycin +etoposide + cisplatin (BEP), etoposide +ifosfamide + cisplatin (VIP) or ifosfamide + carboplatin + etoposide (ICE). 13 Therefore, this patient received five cycles of chemotherapy with the TP regimen after surgical resection of the metastatic lesion in the pancreas.…”

“…This immunohistochemical phenotype was consistent with a diagnosis of PSTT. 4,12 The occurrence of PSTT can follow term pregnancy, premature delivery, hydatidiform mole and choriocarcinoma, with an interval between the occurrence and previous pregnancy ranging from months to several years. 4 PSTT is relatively resistant to chemotherapy compared with other GTNs.…”

“… 7 PSTT is a rare pathological subtype of GTN that does not present with typical symptoms and diagnosis mostly depends on detailed histological examination. 4 According to the medical history and the postoperative results, this current patient was re-evaluated and diagnosed with PSTT. In this current case, after so many cycles of chemotherapy and based on the pathology report after resection of the pancreatic mass, the patient was diagnosed with PSTT.…”

“…3 PSTT is a very rare type of GTN that only accounts for approximately 0.2% of cases and it originates from intermediate trophoblastic cells. 4 Choriocarcinomas can be subdivided into gestational and non-gestational choriocarcinomas. Non-gestational choriocarcinoma is also known as extragonadal choriocarcinoma or primary choriocarcinoma.…”