Challenges in the Management of Placental Site Trophoblastic Tumor

Placental site trophoblastic tumor (PSTT) is a rare neoplasm of intermediate trophoblastic cells of the placenta. Two cases of PSTT are presented. A 24‑year‑old G2P2 female presented with a flat vaginal ulcerative lesion diagnosed as PTSS 2 years after a term pregnancy. Beta human chorionic gonadotropin (β‑HCG) level was 110 mIU/mL and uterus was diffusely enlarged. Total abdominal hysterectomy was performed and on follow up, her serum β‑HCG level was undetectable. The second case is a 33‑year‑old female with a history of vaginal bleeding referred to hospital. She had myomectomy and the pathology was reported as leiomyosarcoma. We doubted the pathology result. By further pathological investigations and increase in β‑HCG consistent with PSTT, the diagnosis was made. The patient had hysterectomy. For both cases no adjuvant therapy was done and there has not been any sign of recurrence in them. It is thus concluded that complete resection in PSTT, could achieve long‑term remission.