Placental Site Trophoblastic Tumor with lung metastases as cause of death in a young patient: A case report

Catia Colecchi, Sara Partemi, Natalia Minelli, Fidelia Cascini, Riccardo Rossi, Ezio Fulcheri, Vincenzo L. Pascali, Antonio Oliva

Research output: Contribution to journalArticlepeer-review

Abstract

Placental Site Trophoblastic Tumor (PSTT) is a rare form of Gestational Trophoblastic Disease (GTD). Approximately 200 cases have been reported in the literature. This disease has unpredictable biological behavior, whereas approximately 10-15% have clinically malignant evolution. We present the case of a 21-year old woman at first pregnancy without known previous abortion at 25 weeks of amenorrhea who was admitted to the hospital for hyperemesis, hepatic problems and important weight loss registered during the last few months. Few days after the admission, the patient suddenly died before the doctors can reach a diagnosis. A forensic investigation for medical malpractice was initiated. Samples collected from uterus at the autopsy revealed large trophoblastic cells with eosinophilic cytoplasm. Deposition of fibrinoid material was noticed between trophoblastic cells. Tumor cells dissected through the myometrium and invaded into the vascular spaces. Specimens of the lungs revealed numerous small neoplastic emboli into the vessels.We show autopsy and histological findings of PSTT in a young woman, which are very rarely described in the literature and we discuss the medico-legal implications related to the great difficulties of the gynecologists who faced this rare condition in term of diagnosis and prediction of biological behavior, outlining effective therapeutic approaches.

Original languageEnglish
Pages (from-to)1060-1063
Number of pages4
JournalPlacenta
Volume32
Issue number12
DOIs
Publication statusPublished - Dec 2011

Keywords

  • Gestational Trophoblastic Disease (GTD)
  • HPL (human placental lactogen)
  • Mel-CAM (CD 146)
  • Placental Site Trophoblastic Tumor (PSTT)

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Reproductive Medicine
  • Developmental Biology

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