Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 41-year-old woman who 5 years earlier had a hysterectomy for a placental site trophoblastic tumor (formerly called trophoblastic pseudotumor) was readmitted to the hospital with pelvic recurrence and multiple lung metastases. Despite an initial decrease in the size of the lung metastases and concomitant lowering of the serum values of human chorionic gonadotropin (beta-HCG) from 2,200 to 40 ng/ml, combined chemotherapy became ineffective. The patient died 4 months later with widespread metastases. The clinical course and the autopsy findings of this case are reported and compared with the two similar cases reported in the literature.
 ...
PMID:Placental site trophoblastic tumor (trophoblastic pseudotumor) of the uterus with metastases and fatal outcome. Clinical and autopsy observations of a case. 631 Oct 36

An immunohistochemical and flow cytometric DNA study of two cases of metastasizing placental site trophoblastic tumor are presented. One patient aged 29 died rapidly of widespread metastases despite hysterectomy and multiagent chemotherapy. The patient had a low level of serum HCG. The course was complicated by the presence of a nephrotic syndrome. The other patient aged 34 had a vaginal metastasis and high levels of serum HCG, and was alive without disease for 9 years after hysterectomy and chemotherapy. Histologically, these tumors were characterized by a monomorphic trophoblastic cell population, probably derived from intermediate trophoblast in the placental site. The mitotic rate in these tumors was 2-4/10 high-power fields. Immunohistochemically, many tumor cells contained human placental lactogen and placental alkaline phosphatase. Beta-unit chorionic gonadotropin was present in many cells of the second patient, and only focally in the first. All specimens including the curettaged and metastatic lesions revealed a diploid DNA content in both cases. Neither DNA ploidy nor S-phase fraction was associated with survival of patient. Since predicting the biologic behavior of placental site trophoblastic tumor is very difficult, making a correct diagnosis on endometrial curettings, hysterectomy, and monitoring serum HCG level is essential in patients with this tumor.
 ...
PMID:Metastasizing placental site trophoblastic tumor. An immunohistochemical and flow cytometric study of two cases. 839 53

The placental site trophoblastic tumor (PSTT) is the rarest form of trophoblastic disease and shows a wide spectrum of symptoms. A 32-year-old women is presented with PSTT after abruptio in the 7th week of gestation which was initially misdiagnosed as cervical carcinoma on cervical punch biopsy. Therefore, a radical Wertheim-Held hysterectomy was done. The uterus showed a small tumor restricted to the cavum with no cervical infiltration, resembling in all histologic and immunohistochemical features a PSTT. The pelvic lymph nodes showed no metastases. There was no nephrotic syndrome. The patient showed no evidence of disease fourteen months after hysterectomy.
 ...
PMID:Placental site trophoblastic tumor (PSTT) initially misdiagnosed as cervical carcinoma. 919 8

Since our publication, which first defined the malignant potential of placental site trophoblastic tumor (PSTT), we have had a keen interest in this rare, unique entity. This histologic entity is noted by its monomorphic population of trophoblast-like cells which are classified as originating in the intermediate trophoblast. These cells contain hymman placental lactogen (HPL). This is in contrast to cytotrophoblastic and syncytiotrophblastic tissues as the histologic, cytologic and immunohistochemical stain characteristics are disparate. Its rarity and the wide spectrum of clinical behavior combined with the lack of sensitivity of serum levels of beta hCG in predicting disease recurrence and spread have lead to anecdotal reports outlining clinical management. Most discerning to the clinician is the high mortality of metastatic placental site trophoblastic tumor. At our institution, we have treated two patients with a metastatic disease with a successful conclusion. The durability of responses is 3 and 8 years. This report will present these patients in detail and define the important characteristics of successful treatment. The use of dose-intensive, multi-agent chemotherapy, early intervention when metastatic disease is discovered, imaging techniques to define disease spread, surgery for localized disease and the use of growth factors, most notably granulocyte colony-stimulating factor (G-CSF), are the fundamentals of clinical care of placental site trophoblastic tumor in patients with metastatic placental site trophoblastic tumor.
 ...
PMID:Metastatic placental site trophoblastic tumor. 983 15

Trophoblastic disease occasionally presents with apparent metastases that turn out to be lesions not associated with the trophoblastic tumor. In this article, we present one case of a cerebellar hemangioma, two of lung and mediastinal teratoma, and one of pulmonary granuloma masquerading as metastases from trophoblastic disease. If an apparent metastasis associated with trophoblastic tumor does not accord with the clinical diagnosis, look for an independent cause.
 ...
PMID:Phantom metastases in trophoblastic disease. 1124 Jun 62

We report the first case of placental site trophoblastic tumor following in vitro fertilization. A 32-year-old woman presented with a vaginal polyp diagnosed 11 months after a successful fertilization, resulting in the delivery of a term male baby, but followed by persistent amenorrhea. The diagnosis of PSTT was done on examination of the vaginal polyp and the curettage specimen and was confirmed after hysterectomy. The patient was well 30 months later. The value of initial metastases limited to the pelvis and the role of in vitro fertilization in the pathogenesis of the tumor are discussed.
 ...
PMID:[Placental site trophoblastic tumor of the uterus after in vitro fertilization. A case report with initial vaginal metastasis]. 1290 26

Placental site trophoblastic tumor (PSTT) is a well-defined entity in the female genital tract. In the male genital tract, a single case of PSTT in the testis of a young boy has been reported. Despite its very rare occurrence, PSTT of the testis has been incorporated in the latest WHO classification of tumors of the male genital tract. In this article, a case of a PSTT in a late retroperitoneal recurrence of a testicular nonseminomatous germ cell tumor in an adult male patient is presented. The tumor was discovered due to an elevated serum level of beta-human chorionic gonadotropin 4 years after chemotherapy. Upon review of the primary testicular tumor, small foci of intermediate trophoblastic tumor cells were discerned. This case illustrates that tumor cells resembling intermediate trophoblastic cells may metastasize to regional retroperitoneal lymph nodes. Because of their resistance to chemotherapy, these cells may invade surrounding tissue in due time, acquiring the typical morphology of PSTT.
 ...
PMID:Placental site trophoblastic tumor in a late recurrence of a nonseminomatous germ cell tumor of the testis. 1516 78

The non-villous forms of gestational trophoblastic disease (GTD) include a wide range of morphologic different lesions and cover a wide range of differential diagnosis. Choriocarcinomas (CCA) represent the most malignant form displaying a dimorphic pattern with proliferation of syncytio- and zytotrophoblast. An early start of chemotherapy is of great prognostic impact. Placental site nodule (PSN) and exaggerated placental site (EPS) are non-neoplastic lesions of the intermediate trophoblast without tumorous appearance, whereas placental site trophoblastic tumor (PSTT) and epitheloid trophoblastic tumor (ETT) represent tumorous neoplasms with a potential for local invasion and metastases. PSNs are incidental findings of highly polymorphic cells. In EPS chorionic villi are almost present, endometrial glands and spiral arteries are completely engulfed by intermediate trophoblastic cells without necroses. In PSTT the monomorphic, occasional multinucleated giant cells separating individual muscle fibers and charactersitically blood vessel walls are extensively replaced by trophoblastic cells and fibrinoid material. The ETT consists large necrotic areas with hyalinisation. Typically small blood vessels with preserved walls are located within the center of glycogen-rich monomorphous proliferation of trophoblastic cells.
 ...
PMID:[Gestational trophoblastic disease. Non-villous forms of gestational trophoblastic disease]. 1518 92

Placental site trophoblastic tumor is a rare neoplasm that arises from intermediate trophoblasts and shows diversity of biological behaviors, resulting in the absence of consistency in treatment modalities. A case of placental site trophoblastic tumor that extended to the cervix, with primary manifestation of amenorrhea and yellow foul-smelling vaginal discharge, is presented. Total abdominal hysterectomy was performed initially, and serial measurements of human chorionic gonadotropin levels were obtained. She was admitted with metastases to brain and lung 1.5 years after surgery. Combination chemotherapy (etoposide-methotrexate-dactinomycin/cyclophosphamide-vincristine) and radiotherapy were administered. There was no significant response to chemoradiotherapy. Despite changing chemotherapy regimen, she is still alive with progressive disease.
 ...
PMID:Placental site trophoblastic tumor in a patient with brain and lung metastases. 1522 35

Cases of metastatic placental site trophoblastic tumor (PSTT) have a very poor prognosis because these tumors tend to be less sensitive to chemotherapy than other types of gestational trophoblastic disease. We describe the case of a 25-year-old woman who presented with occipital tumor and abnormal vaginal bleeding. Hysterectomy, bilateral salpingo-oophorectomy, and occipital tumor removal revealed a primary PSTT in the uterus, with ovarian and occipital subaponeurotic metastases. She received etoposide, methotrexate, actinomycin-D/cyclophosphamide, vincristine chemotherapy and had a complete clinical remission. Fifteen months later, she had a recurrent subaponeurotic occipital tumor invading the cranium and underwent tumor removal along with cranial bone followed by local irradiation. She was then treated with etoposide, cis-platinum/etoposide, methotrexate, actinomycin-D chemotherapy and again had a remission for 5 months. The patient, however, had a left parietal subaponeurotic tumor, invading the dura mater, and received local irradiation. Soon after, she developed left orbital bone metastasis, treated by local irradiation. These bone metastases responded to the radiation completely. However, multiple organ metastases were found, and she died of the disease. This represents the first case of PSTT with initial subaponeurotic metastasis in a living patient. New modalities of treatment for high-risk or metastatic PSTT need to be developed.
 ...
PMID:Placental site trophoblastic tumor presenting as subaponeurotic metastasis. 1582 31


<< Previous 1 2 3 4 5 Next >>