Skin metastases from malignant gestational trophoblastic disease: Report of two cases

Scalp Metastases Mimicking Alopecia Areata

“…Kurman in 1976 further characterized this tumor as a proliferation of the intermediate trophoblastic cell, referring to it as trophoblastic pseudotumor, and noted the benign nature of his 12 cases 8 . Twiggs 9 and others 2,4,10–17 subsequently noted malignant behavior in some of the tumors, and the term was revised in 1981 by Scully and Young 18 to the currently accepted “placental site trophoblastic tumor.”…”

“…That this count was low in our patient, and that our patient has done relatively well clinically despite metastases, lends support to the assertions that mitotic counts are useful in estimating prognosis. PSTT is metastatic in approximately 10–15% of cases, with about 15 such occurrences thus far reported in the English literature 1,2,4,9,10,12–15,17,18,24 . All of these cases with metastases presented with gynecologic symptoms from the primary rumor such as abnormal vaginal bleeding, amenorrhea, or pain, with one case of recurrence presenting with simultaneous gynecologic symptoms and hemoptysis 15 .…”

Choriocarcinoma of the Testis Metastatic to the Skin

“…The patient died and at autopsy metastatic choriocarcinoma was found in the brain, lungs, liver, kidneys, spleen, jejunum, and lymph nodes, but careful histologic examination failed to locate the primary site of the choriocarcinoma. Ertüngealp et al 6 reported two histologically confirmed cases of skin metastases from malignant gestational trophoblastic disease. Curiously, both women showed cutaneous metastatic nodules in the gluteal region and, in the second case, beta‐HCG was found with immunoperoxidase technique within the cytoplasm of syncytiotrophoblastic cells of the cutaneous metastasis.…”

“…Choriocarcinoma has a distinct propensity to spread hematogenously and the principal sites of involvement include lung, liver, intestines, spleen, adrenals, and brain 9 . Reports of metastatic choriocarcinoma infrequently mention the skin as a site of metastasis 6,7,12–15 . Reingold 12 reported 32 necropsied cases with cutaneous metastases from internal carcinoma.…”

“…The primary tumor was first diagnosed by the biopsy of a single metastatic nodule that appeared on the chest. We also reviewed the literature of previously documented cases of choriocarcinoma metastatic to the skin and there are only two previously reported cases 6,7 with demonstration by immunoperoxidase staining of beta‐HCG production in the syncytiotrophoblastic cells of the cutaneous metastasis.…”