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Successful management of metastatic placental site trophoblastic tumor with multiple pulmonary resections
Nicole Carlson1, William E Winter, Thomas C Krivak
1Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Walter Reed Army Medical Center, 6900 Georgia Avenue NW, Washington, DC 20307, USA.
Introduction:
Placental site trophoblastic tumor (PSTT) is an uncommon variant of gestational trophoblastic disease. Most of these tumors are confined to the uterus and treated with a simple hysterectomy. However, 30% of these patients will present with metastatic disease. These patients are typically treated with a hysterectomy followed by adjuvant multiagent chemotherapy. Unfortunately, PSTT is relatively resistant to chemotherapy when compared to other forms of gestational trophoblastic disease. Consequently, these patients have a poor prognosis.
Case:
We present a case report of a 26-year-old female with multiple metastatic lesions to the lungs unresponsive to chemotherapy who was managed with multiple pulmonary resections. She has remained clinically free of disease at 28 months of follow up.
Conclusion:
A patient with metastatic PSTT was successfully managed with radical surgical resection of chemotherapy-resistant sites.