Placental site trophoblastic tumor and choriocarcinoma: an unusual presentation

Gari, Abdulrahim

doi:10.1186/s13104-015-1693-8

Cited by 12 publications

(7 citation statements)

References 6 publications

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“…Although ETT was recognized as a distinct GTN entity in 1998 by Shih and Kurman (2), ETTs combined with other gestational trophoblastic have been reported. MGTNs are extremely rare, and a review of English literature revealed that in addition to our case, there are 36 other MGTDs (Table 1) (2)(3)(4)6,(8)(9)(10)(11)(12)(13)(14).…”

Section: Discussionmentioning

confidence: 52%

Coexisting Epithelioid Trophoblastic Tumor and Placental Site Trophoblastic Tumor During Asymptomatic Relapse: A Case Report and Literature Review

Aiob

Cohen

Naskovica

et al. 2021

International Journal of Gynecological Pathology

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Gestational trophoblastic neoplasms are a group of trophoblastic tumors that include choriocarcinoma (CC), epithelioid trophoblastic tumors (ETTs), and placental site trophoblastic tumors (PSTTs). Mixed gestational trophoblastic neoplasms include combinations of CCs with ETTs and/or PSTTs; combinations of ETTs and PSTTs have also been described. This report describes the case of a 49-yr-old female with mixed ETT and PSTT discovered due to menstrual delay and a positive beta-human chorionic gonadotropin in serum 11 yr after normal pregnancy; it is an asymptomatic recurrence of the neoplasm after 2 yr. Moreover, only the ETT recurred without evidence of PSTT by biopsy and without any increase in human chorionic gonadotropin levels, even though human chorionic gonadotropin was positive in the first onset of the disease. We also reviewed published English literature, which revealed that there are only 36 cases of mixed trophoblastic tumors to date, of which pure mixed ETT and PSTT were reported only in four cases including our case. The most common combination is CC admixed with an ETT (52%), followed by CC with PSTT in 30.5%. CC admixed with an ETT and/ or PSTT account for 83% of the cases, of which pure mixed ETT and PSTT were reported only in 4 cases (11%). The rarity of this condition entails reporting of all cases to facilitate future research and clinical management.

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Section: Discussionmentioning

confidence: 52%

Coexisting Epithelioid Trophoblastic Tumor and Placental Site Trophoblastic Tumor During Asymptomatic Relapse: A Case Report and Literature Review

Aiob

Cohen

Naskovica

et al. 2021

International Journal of Gynecological Pathology

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“…Mixed GTNs are extremely rare, with only 20 mixed trophoblastic tumors having been reported [ 2 – 14 ], including our patient’s case. According to the literature, most mixed GTNs have occurred in patients of reproductive age (age range 15–60 years) and were usually associated with a previous gestational event [ 2 ].…”

Section: Discussionmentioning

confidence: 79%

Epithelioid trophoblastic tumor coexisting with choriocarcinoma around an abdominal wall cesarean scar: a case report and review of the literature

Yang¹,

Li²,

Zhang³

et al. 2020

J Med Case Reports

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Background Mixed gestational trophoblastic neoplasms are extremely rare and comprise a group of fetal trophoblastic tumors including choriocarcinomas, epithelioid trophoblastic tumors, and placental site trophoblastic tumors. We present a case of a patient with extrauterine mixed gestational trophoblastic neoplasm adjacent to the abdominal wall cesarean scar. On the basis of a literature review, this type of case has never been reported before due to the unique lesion location and low incidence. Case presentation Our patient was a 39-year-old Chinese woman who had a history of two cesarean sections and one miscarriage. She had a recurrent anterior abdominal wall mass around her cesarean scar, and the mass was initially suspected of being choriocarcinoma of unknown origin. The patient had concomitant negative or mildly increased serum β-human chorionic gonadotropin at follow-up and no abnormal vaginal bleeding or abdominal pain. However, she underwent local excision twice and had two courses of chemotherapy with an etoposide and cisplatin regimen. She finally opted for exploratory laparotomy with abdominal wall lesion removal, subtotal hysterectomy, bilateral salpingectomy, and left ovarian cyst resection, which showed the abdominal wall lesion, whose components were revealed by microscopy and immunohistochemical staining to be approximately 90% epithelioid trophoblastic tumors and 10% choriocarcinomas from a solely extrauterine mixed gestational trophoblastic neoplasm around an abdominal wall cesarean scar. Conclusions It is worth noting whether epithelioid trophoblastic tumor exists in the setting of persistent positive low-level β-human chorionic gonadotropin. More studies are required to provide mechanistic insights into these mixed gestational trophoblastic neoplasms.

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“…27,28 During the course of many years and following intensive chemotherapy, there was recurrence as choriocarcinoma; we note that both of these forms of gestational trophoblastic neoplasia rarely develop simultaneously. 29 The lesson is that epithelioid trophoblast cells are easily misinterpreted as neoplastic squamous cells, a difficulty that was compounded in this case by the history of cervical squamous cell carcinoma, the older age of the patient, and the absence of known gestational trophoblastic disease. This is especially likely to be the case for trophoblastic neoplasms resembling the epithelioid trophoblastic tumor and the placental site trophoblastic tumor.…”

Section: Discussionmentioning

confidence: 87%

Fluorescence In Situ Hybridization for the X and Y Chromosome Centromeres Helps Differentiate Between Gestational and Nongestational Choriocarcinoma in Clinically Ambiguous Cases

Whaley

Dougherty

Cheng

et al. 2019

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Gestational choriocarcinoma usually presents during the reproductive years, typically within 1 year of pregnancy, although presentation remote from pregnancy also occurs and may cause confusion with other tumors, including choriocarcinoma of germ cell origin and somatic carcinomas with choriocarcinomatous differentiation. It is important to separate these tumors for treatment and prognostic reasons. Objective.— To assess the utility of fluorescence in situ hybridization for the X and Y chromosome centromeres in determining the gestational origin of clinically ambiguous extrauterine choriocarcinomas in women. Design.— A review of female patients with extrauterine choriocarcinomas who had no evidence of prior gestational trophoblastic disease was performed. Samples were analyzed by fluorescence in situ hybridization for the X and Y chromosome centromeres using standard methodologies. Results.— Five cases met the criteria, all of which displayed trophoblastic cells and necrosis. Three cases (60%) had Y chromosomes by fluorescence in situ hybridization, which confirmed gestational origin. Although the 2 cases without a Y chromosome would ordinarily require molecular genotyping for paternal genetic material to establish gestational origin, in one of these cases a subsequent recurrence of yolk sac tumor allowed confirmation of its mediastinal origin. Conclusions.— Fluorescence in situ hybridization for detection of the X and Y chromosome centromeres is an effective screening test for gestational choriocarcinoma. It provided a definitive diagnosis of metastatic gestational choriocarcinoma in 3 of 5 potential cases that lacked a clinical history of gestational trophoblastic disease. An additional benefit is that more laboratories have the capability to perform fluorescence in situ hybridization than can perform molecular genotyping for definitive diagnosis.

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Placental site trophoblastic tumor and choriocarcinoma: an unusual presentation

Cited by 12 publications

References 6 publications

Coexisting Epithelioid Trophoblastic Tumor and Placental Site Trophoblastic Tumor During Asymptomatic Relapse: A Case Report and Literature Review

Coexisting Epithelioid Trophoblastic Tumor and Placental Site Trophoblastic Tumor During Asymptomatic Relapse: A Case Report and Literature Review

Epithelioid trophoblastic tumor coexisting with choriocarcinoma around an abdominal wall cesarean scar: a case report and review of the literature

Fluorescence In Situ Hybridization for the X and Y Chromosome Centromeres Helps Differentiate Between Gestational and Nongestational Choriocarcinoma in Clinically Ambiguous Cases

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