Fertility sparing therapy in a patient with placental site trophoblastic tumor: a case report

Gynecol Oncol. 2006 Dec;103(3):1141-3. doi: 10.1016/j.ygyno.2006.07.039. Epub 2006 Sep 27.


Background: Placental site trophoblastic tumor (PSTT) is a rare form of gestational trophoblastic disease (GTD) that is generally resistant to conventional chemotherapeutic treatment. Patients with localized disease are usually managed with hysterectomy.

Case: A 29-year-old female presented with vaginal bleeding and an elevated serum human chorionic gonadotropin (HCG). After initial observation, the patient experienced continued vaginal bleeding and a persistently elevated HCG. Therefore, she underwent a dilation and curettage and final pathology revealed PSTT. Since the patient desired future fertility, the patient received combination chemotherapy with etoposide, methotrexate, actinomycin-D followed by etoposide and cisplatin (EMA-EP). The patient had a complete response to chemotherapy and subsequently delivered a term infant 2 years after completion of therapy.

Conclusion: PSTT is thought to be a chemoresistant disease and the preferred method of treatment is hysterectomy or local uterine resection. However, combination chemotherapy is a reasonable option in a properly counseled patient who strongly desires future fertility.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Combined Modality Therapy
  • Curettage
  • Diagnosis, Differential
  • Female
  • Fertility*
  • Humans
  • Pregnancy
  • Trophoblastic Tumor, Placental Site / diagnosis*
  • Trophoblastic Tumor, Placental Site / pathology
  • Trophoblastic Tumor, Placental Site / therapy
  • Uterine Neoplasms / diagnosis*
  • Uterine Neoplasms / pathology
  • Uterine Neoplasms / therapy