Resolution of pulmonary metastases with chemotherapy in a patient with placental site trophoblastic tumor

Abstract

Placental site trophoblastic tumor (PSTT), a rare variant of gestational trophoblastic disease, was first described in 1976. PSTT is usually seen in young women, generally treated by hysterectomy, and is associated with a 20% fatality rate. The development of metastases secondary to PSTT is associated with an extremely poor prognosis. Metastatic PSTT has generally been resistant to chemotherapy although one complete and some partial responses have been noted previously. We report a case of a complete chemotherapeutic response in a patient with pulmonary metastases.

Placental site trophoblastic tumor (PSTT) in mother and child: First report of PSTT in infancy

“…However, there are several reports of metastatic disease being cured with chemotherapy [1,19,24,26]. In the mother herein described the lung metastases disappeared and the serum hCG became normal after high dose methotrexate/etoposide treatment.…”

Metastasizing placental site trophoblastic tumor: Immunohistochemical and DNA analysis 2 case reports and a review of the literature

“…Including our cases, approximately 21 cases of metastatic PSTT have been reported [17,21]. Lung metastases have been described only in a few cases [1,2,5,8,10,17].…”

Placental site trophoblastic tumor presenting with scalp metastases

“…~-hCG is normal in 23%, slightly elevated in 46%, and moderately elevated in 31% of cases (n'12). Metastatic disease has been reported in lung, vagina, liver, brain, kidney, stomach, spleen, small bowel, lymph nodes, and pancreas (1°' [12][13][14][15][16][17][18]. To our knowledge, this report describes the first report of skin metastases with PSTF.…”

“…In contrast to other forms of GTD, chemotherapy is not as effective with multiple reports of poor outcomes in the literature (1s-17). (14) Single agent chemotherapy is ineffective . Numerous chemotherapy regimens have been utilized with varying © 1996 IGCS, International Journal of Gynecological Cancer 6, 333-336 success including but not limited to combinations of methotrexate, actinomycin-D, etoposide, cyclophosphamide, cisplatin and vincristine.…”