Placental site trophoblastic tumours and the concept of fertility preservation

BJOG. 2012 Feb;119(3):369-74; discussion 374. doi: 10.1111/j.1471-0528.2011.03230.x. Epub 2011 Dec 13.


The standard management of placental site trophoblastic tumours (PSTTs) is a radical hysterectomy with pelvic lymph node sampling. We present five cases to demonstrate a modified Strassman procedure (MSP), which is an alternative fertility-sparing technique. Each had a presumed solitary uterine PSTT. Following surgery, one patient remained in remission with her fertility intact. The other four underwent a completion hysterectomy because of incomplete excision of the disease. No residual disease was later found in two of these four uteri. This treatment should only be offered after extensive counselling. We intend to investigate the use of intraoperative frozen section analysis with cold-knife dissection in future.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Female
  • Fertility Preservation*
  • Gynecologic Surgical Procedures / methods*
  • Humans
  • Hysterectomy
  • Pregnancy
  • Retrospective Studies
  • Treatment Outcome
  • Trophoblastic Tumor, Placental Site / surgery*
  • Uterine Neoplasms / surgery*