TY - JOUR
T1 - Placental Site Trophoblastic Tumor with lung metastases as cause of death in a young patient
T2 - A case report
AU - Colecchi, Catia
AU - Partemi, Sara
AU - Minelli, Natalia
AU - Cascini, Fidelia
AU - Rossi, Riccardo
AU - Fulcheri, Ezio
AU - Pascali, Vincenzo L.
AU - Oliva, Antonio
PY - 2011/12
Y1 - 2011/12
N2 - 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.
AB - 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.
KW - Gestational Trophoblastic Disease (GTD)
KW - HPL (human placental lactogen)
KW - Mel-CAM (CD 146)
KW - Placental Site Trophoblastic Tumor (PSTT)
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U2 - 10.1016/j.placenta.2011.10.006
DO - 10.1016/j.placenta.2011.10.006
M3 - Article
C2 - 22027660
AN - SCOPUS:84859458864
VL - 32
SP - 1060
EP - 1063
JO - Placenta
JF - Placenta
SN - 0143-4004
IS - 12
ER -