Treatment of placental site trophoblastic tumor with hysterotomy and uterine reconstruction.
Obstet Gynecol
; 88(4 Pt 2): 696-9, 1996 Oct.
Article
em En
| MEDLINE
| ID: mdl-8841257
ABSTRACT
BACKGROUND:
Placental site trophoblastic tumor is an unusual variant of gestational trophoblastic neoplasia that is usually confined to the uterus, although 10% of patients have metastases. Because this tumor occurs in women of reproductive age, preservation of fertility may be relevant. Therefore, local excision of placental site trophoblastic tumor by hysterotomy may have a place in management. CASE A 25-year-old woman, gravida 1, para 1, presented with irregular bleeding. Uterine curettage revealed intermediate trophoblasts that on immunostaining were positive for hCG and human placental lactogen, consistent with placental site trophoblastic tumor. Endovaginal ultrasonography and magnetic resonance imaging demonstrated tumor localized to the anterior fundal myometrium. The patient underwent local excision of the tumor by hysterotomy followed by uterine reconstruction. Pathologic examination confirmed that the surgical margins were free of tumor. The patient has had no recurrence. Two subsequent pregnancies resulted in two spontaneous abortions. A third pregnancy was carried to term. The patient was delivered by cesarean because of the hysterotomy. The hysterotomy scar was intact at cesarean.CONCLUSION:
Hysterectomy has been recommended by most authors for treatment for placental site trophoblastic tumor. In some patients with localized placental site trophoblastic tumor who desire preservation of fertility, more conservative surgical therapy may be considered.
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Uterinas
/
Útero
/
Tumor Trofoblástico de Localização Placentária
Tipo de estudo:
Diagnostic_studies
Limite:
Adult
/
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
Obstet Gynecol
Ano de publicação:
1996
Tipo de documento:
Article
País de afiliação:
Estados Unidos