Organ-preserving treatment of a patient with a trophoblastic tumor of the placental bed (clinical observation and literature review)

Cover Page

Cite item

Full Text

Abstract

Placental site trophoblastic tumor (PSTT) is а rare form of gestational trophoblastic neoplasia (GTN), accounting 0,2 % of total cases of GTN. PSTTs occur in women of childbearing age and most of them have strong desire to preserve fertility. PSSTs are tumors with unpredictable biological behavior, high chemo-resistance and possibly fatal outcome in case of metastatic disease.

Hysterectomy is the primary treatment of choice in early disease. We report a rare clinical case of fertility sparing treatment for PSTT.

About the authors

M. N. Tikhonovskaya

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Author for correspondence.
Email: rommary03@mail.ru
ORCID iD: 0000-0003-3349-0854

Mariya Nikolaevna Tikhonovskaya

24 Kashirskoe Shosse, Moscow 115522

Russian Federation

A. A. Rumyantsev

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: fake@neicon.ru
ORCID iD: 0000-0003-4443-9974

24 Kashirskoe Shosse, Moscow 115522

Russian Federation

L. M. Kappusheva

N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: fake@neicon.ru
ORCID iD: 0000-0003-2804-2870

1 Ostrovityanova St., Moscow117997

Russian Federation

A. S. Shevchuk

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: fake@neicon.ru
ORCID iD: 0000-0002-9259-4525

24 Kashirskoe Shosse, Moscow 115522

1 Ostrovityanova St., Moscow117997

Russian Federation

References

  1. Kurman R.J., Scully R.E., Norris H.J. Trophoblastic pseudotumor of the uterus: an exaggerated form of syncytial endometritis simulating a malignant tumor. Cancer 1976;38(3):1214–26. doi: 10.1002/1097-0142(197609)38:33.0.co;2-j
  2. Scully R.E., Young R.H. Trophoblastic pseudotumor: a reappraisal. Am J Surg Pathol 1981;5(1):75–6. doi: 10.1097/00000478-198101000-00010
  3. Behtash N., Karimi Zarchi M. Placental site trophoblastic tumor. J Cancer Res Clin Oncol 2008;134(1):1–6. doi: 10.1007/s00432-007-0208-y.
  4. Martusova U.S., Chekalova E.A., Meshcheryakova L.A., Moroz E.A. Ulrasound diagnostic experience in placental cite trophoplastic disease. Ultrazvukovaya i Funktsionalnaya Diagnostika = Ultrasound and Functional Diagnostic 2014; 4:42–9. (In Russ.).
  5. Chiofalo B., Palmara V., Laganà A.S. et al. Fertility sparing strategies in patients affected by placental site trophoblastic tumor. Curr Treat Options Oncol 2017;18(10):58. doi: 10.1007/s11864-017-0502-0
  6. Tsuji Y., Tsubamoto H., Hori M. et al. Case of PSTT treated with chemotherapy followed by open uterine tumor resection to preserve fertility. Gynecol Oncol 2002;87(3):303–7. doi: 10.1006/gyno.2002.6827
  7. Saso S., Haddad J., Ellis P. et al. Placental site trophoblastic tumours and the concept of fertility preservation. BJOG 2012;119(3):369–74. doi: 10.1111/j.1471-0528.2011.03230.x
  8. Jiang S., Zhao J., Shi X. et al. Retrospective analysis of clinical features and fertility outcomes with fertility-sparing treatment of placental site trophoblastic tumor. Gynecol Oncol 2023;171:1–8. doi: 10.1016/j.ygyno.2023.02.002
  9. Shen X., Xiang Y., Guo L. et al. Fertility-preserving treatment in young patients with placental site trophoblastic tumors. Int J Gynecol Cancer 2012;22(5):869–74. doi: 10.1097/IGC.0b013e31824a1bd6
  10. Horowitz N.S., Iskander R.N., Edelman M.R. et al. Epidemiology, diagnosis, and treatment of gestational trophoblastic disease: a Society of Gynecologic Oncology Evidenced-Based Review and Recommendation. Gynecol Oncol 2021;163(3):605–13. doi: 10.1016/j.ygyno.2021.10.003
  11. Chang Y.L., Chang T.C., Hsueh S. et al. Prognostic factors and treatment for placental site trophoblastic tumor – report of 3 cases and analysis of 88 cases. Gynecol Oncol 1999;73(2):216–22. doi: 10.1006/gyno.1999.5344
  12. Lan C., Li Y., He J., Liu J. Placental site trophoblastic tumor: lymphatic spread and possible target markers. Gynecol Oncol 2010;116(3):430–7. doi: 10.1016/j.ygyno.2009.10.56
  13. National Comprechensive Cancer Network. Available at: https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1489
  14. Seckl M.J., Sebire N.J., Fisher R.A. et al. Gestational trophoblastic disease: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013;24(6):39–50. DOI: 10/1093/annonc/mdt345
  15. Ulrich E.A., Tyulandina A.S., Protsenko S.A., Urmancheeva A.F. Practical recommendations for the drug treatment of malignant trophoblastic tumors. Malignant tumors: Practical recommendations RUSSCO 2022;12:276–86. doi: 10.18027/2224-5057-2022-12-3s2-276-286. Available by: https://rosoncoweb.ru/standarts/RUSSCO/2022/2022-15.pdf
  16. Gadducci A., Carinelli S., Guerrieri M.E., Aletti G.D. Placental site trophoblastic tumor and epithelioid trophoblastic tumor: clinical and pathological features, prognostic variables and treatment strategy. Gynecol Oncol 2019;153(3):684–93. doi: 10.1016/j.ygyno.2019.03.011
  17. Feltmate C.M., Genest D.R., Wise L. et al. Placental site trophoblastic tumor: a 17-year experience at the New England Trophoblastic Disease Center. Gynecol Oncol 2001;82(3):415–9. doi: 10.1006/gyno.2001.6265
  18. Zhao J., Lv W.G., Feng F.Z. et al. Placental site trophoblastic tumor: a review of 108 cases and their implications for prognosis and treatment. Gynecol Oncol 2016;142(1):102–8. doi: 10.1016/j.ygyno.2016.05.006
  19. Deng L., Zhang J., Wu T., Lawrie T.A. Combination chemotherapy for primary treatment of high-risk gestational trophoblastic tumour. Cochrane Database Syst Rev 2013;2013(1):CD005196. doi: 10.1002/14651858.CD005196.pub4
  20. Essel K.G., Bruegl A., Gershenson D.M. et al. Salvage chemotherapy for gestational trophoblastic neoplasia: utility or futility? Gynecol Oncol 2017;146(1):74–80. doi: 10.1016/j.ygyno.2017.04.017
  21. Ajithkumar T.V., Abraham E.K., Rejnishkumar R., Minimole A.L. Placental site trophoblastic tumor. Obstet Gynecol Surv 2003;58(7):484–8. doi: 10.1097/01.OGX.0000077466.40895.32
  22. Numnum T.M., Kilgore L.C., Conner M.G. et al. Fertility sparing therapy in a patient with placental site trophoblastic tumor: a case report. Gynecol Oncol 2006;103(3):1141–3. doi: 10.1016/j.ygyno.2006.07.039
  23. Nie J.C., Chen G.H., Yan A.Q. Liu X S. Postoperative chemotherapy on placental site trophoblastic tumor in early stage: analysis of 60 cases. Eur J Gynaecol Oncol 2017;38(3):431–40.
  24. Schmid P., Nagai Y., Agarwal R. et al. Prognostic markers and long-term outcome of placental-site trophoblastic tumours: a retrospective observational study. Lancet 2009;374(9683):48–55. doi: 10.1016/S0140-6736(09)60618-8
  25. Pfeffer P.E., Sebire N., Lindsay I. et al. Fertility-sparing partial hysterectomy for placental-site trophoblastic tumour. Lancet Oncol 2007;8(8):744–6. doi: 10.1016/S1470-2045(07)70243-7
  26. Loret de Mola J.R., Goldfarb J.M. Reproductive performance of patients after gestational trophoblastic disease. Semi Oncol 1995;22(2):193–7.
  27. Gordeev S.S., Magarramova Z.N., Myshlyakov V.S. et al. Rare malignant tumors in clinical oncoproctology: a single-center 20 years retrospective analysis. Povolzhskiy Onkologicheskiy Vestnik = Oncology Bulletin of the Volga Region 2022;13(4):31–7. (In Russ.).
  28. Gordeev S. S., Rybakov E. G ., Karachun A. M . et al. The optimal surgical volume for anorectal melanoma: a retrospective analysis of the Russian Colorectal Cancer Society Registry. Tazovaya khirurgiya i onkologiya = Pelvic Surgery and Oncology 2022;12(4):11–8. (In Russ.). doi: 10.17650/2686-9594-2022-12-4-11-18

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c)



СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ЭЛ № ФС 77 - 85909 от  25.08.2023.