Çiğdem KILIÇ
Placental site trophoblastic tumor (PSTT), is a rare form of gestational trophoblastic neoplasms (GTN), originating from intermediate trophoblastic cells. PSTT can occur several months, or even years after the pregnancy including molar and ectopic, miscarriage and abortion or a full term normal pregnancy. The incidence of PSTT is approximately 1/100.000 of all pregnancies while its mortality is 25%. Most patients present with nonspecific symptoms and signs. It may secrete human placental lactogen (hPL). Treatment for early stage disease is primarily hysterectomy, however metastatic or recurrent disease often requires a multifaceted approach with chemotherapy and/or surgery. Here we present 5 cases of PSTT treated in our hospital between 1992 and 2017. Two of five patients had term pregnancy, two patients had molar pregnancy and one had abortion prior to diagnosis of PSTT. All patients had elevated serum β-HCG levels and four patients underwent surgery except one including four total abdominal hysterectomies and two pelvic lymphadenectomies. Three patients received chemotherapy (two Methotrexate and one Etoposide, Methotrexate, Actinomycin-D, Cisplatin [EMA-EP]). One patient had metastatic nodules in lung parenchyma at the time of diagnosis. No patient had recurrence during follow-up. The preferred treatment is surgery with hysterectomy± lymphatic sampling. For advanced stage, metastatic and recurrent disease; a combined surgery and chemotherapy treatment is recommended. Adjuvant chemotherapy decision is not clear.

Anahtar Kelimeler: Gestational trophoblastic neoplasm, Intermediate trophoblasts, Placental site trophoblastic tumor