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

Placental site trophoblastic tumor is a rare neoplasm that arises in the trophoblastic tissue of the placental bed. This case report is unusual because of the patient's advanced age at the time of diagnosis and the favorable response of the disease to chemotherapy. Although the clinical course is benign for most patients with placental site trophoblastic tumor, the malignant variant of the disease is characterized by recurrence, relative insensitivity to radiation and chemotherapy, and death. To the authors' knowledge, the 53-year-old woman reported is the oldest patient with histologically confirmed placental site trophoblastic tumor. Initially, surgery, radiation, and multiagent chemotherapy failed to control vaginal and pulmonary metastatic disease. After administration of four treatment cycles of a "second-line" chemotherapeutic regimen consisting of cyclophosphamide and cisplatin, complete clinical and radiologic remission was achieved. The patient's serum level of human chorionic gonadotropin has remained undetectable, and she has been without measurable evidence of disease for 16 months.
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PMID:Placental site trophoblastic tumor in a postmenopausal woman. 170 41

Placental site trophoblastic tumor is a rare trophoblastic neoplasm with the potential for metastatic disease and death. Difficulty diagnosing these tumors and predicting their biologic behavior has clouded attempts to successfully outline individual treatment plans. This review details current knowledge of the origin and clinical behavior of this rare form of trophoblastic disease. The use of various markers to predict clinically aggressive behavior is reviewed critically, and treatment is recommended on the basis of recently published clinical series.
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PMID:Placental site trophoblastic tumor. Diagnosis, clinical behavior and treatment. 184 95

Placental site trophoblastic tumor is a rare variant of trophoblastic disease. The malignant form of this disease with metastasis and death is even more infrequent, as is evident from only five cases in the literature. A 30-year-old black woman who died from this disease is presented. Patients with metastases are at extremely high risk with no reported survivors and must be treated aggressively with chemotherapy and cytoreductive surgery. This type of trophoblastic tumor apparently exhibits a different biologic behavior as compared with choriocarcinoma.
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PMID:Malignant placental site trophoblastic tumor. 299 36

Placental site trophoblastic tumour (PSTT) is a rare form of gestational trophoblastic disease (GTD). We have conducted an analysis of all cases of PSTT managed at the Trophoblastic Disease Screening and Treatment Centre, Sheffield, from 1984 to 1996. During this time we received 4,988 registrations for GTD and managed seven cases of PSTT. A large range of interval between antecedent pregnancy and presentation was observed - the most common presenting symptoms being irregular vaginal bleeding with or without preceding amenorrhoea. Three out of seven patients had disease confined to the uterus at diagnosis and were successfully treated by hysterectomy alone. Two out of seven patients had pulmonary metastases in addition to uterine tumour and were treated with combination chemotherapy--both are alive and well. Of the remaining two patients one had distant and the other loco-regional metastases and both died despite numerous therapeutic interventions.
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PMID:Placental site trophoblastic tumour: a rare but potentially curable cancer. 1073 4

Placental site trophoblastic tumor (PSTT) is very rare. It is an unusual variant of gestational trophoblastic neoplasia usually confined to the uterus, although 10% of patients have metastases. The clinical behaviour of PSTT varies and despite knowledge of its histology, diagnosis of this rare form of trophoblastic disease and prediction of its biological behaviour remains difficult due to only a few cases reported in literature.
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PMID:Metastatic placental site trophoblastic tumor: a case report. 1133 Jul 31

Placental site trophoblastic tumor (PSTT), a rare variant of gestational trophoblastic disease, was first described in 1976. PSTT is usually seen in young women, generally treated by hysterectomy, and is associated with a 20% fatality rate. The development of metastases secondary to PSTT is associated with an extremely poor prognosis. Metastatic PSTT has generally been resistant to chemotherapy although one complete and some partial responses have been noted previously. We report a case of a complete chemotherapeutic response in a patient with pulmonary metastases.
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PMID:Resolution of pulmonary metastases with chemotherapy in a patient with placental site trophoblastic tumor. 1157 78

Placental site trophoblastic tumor (PSTT) is a rare form of gestational trophoblastic disease (GTD), with only 100 cases reported in the literature. Irregular vaginal bleeding has been reported to be the most common presenting symptom, however, spontaneous uterine perforation, mimicking ectopic pregnancy, as the initial presentation is extremely rare, and has not yet been reported in the Chinese literature. Herein, we report a 26-year-old female with PSTT complicating with uterine perforation that mimicked ectopic pregnancy as the initial presentation. She received wide excision of the uterine perforation margin only and now remains disease-free, 2 years after the operation. Reviewing the literature, while most cases of PSTT behave a benign fashion, some exhibit malignant behavior; surgery remains the mainstay of therapy. For patients whose disease is limited to the uterus, simple total abdominal hysterectomy is the treatment of choice. For patients with extensive or metastatic disease, cytoreductive surgery (total abdominal hysterectomy and resection of extrauterine tumor load) combined with chemotherapy should be applied. Etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine (EMA/CO) chemotherapy appears superior to other available chemotherapeutic regimens in the treatment
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PMID:Spontaneous uterine perforation mimicking ectopic pregnancy as the initial presentation of placental site trophoblastic tumor. 1176 87

Placental site trophoblastic tumor (PSTT) is the least common form of gestational trophoblastic disease. The tumor represents a neoplastic transformation of intermediate trophoblastic cells that normally play a critical role in implantation. PSTT can occur after a normal pregnancy, spontaneous abortion, termination of pregnancy, ectopic pregnancy or molar pregnancy. It displays a wide spectrum of behavior, and when metastatic, can be difficult to control even with surgery and chemotherapy. Because of PSTT's rarity, limited information is known about its natural history. Several recent studies have indicated that mitotic index is an important prognostic indicator. Advances in chemotherapeutic regimens have also improved clinical response in metastatic disease.
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PMID:Advances in the understanding of placental site trophoblastic tumor. 1206 71

Placental site trophoblastic tumor is a rare disease. Since its first description in the literature only about 100 cases have been reported. Initially considered a benign pathology, its malignant potential with metastases was later recognized. About 30% of the cases described metastatised, thereby aggravating the prognosis. The therapy is surgical and in cases of metastatised disease has to be supplemented by chemotherapy. A case of placental site trophoblastic tumour with a single metastasis to the left adrenal gland treated with adrenalectomy and chemotherapy is reported.
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PMID:Adrenal metastatic placental site trophoblastic tumor. Case report. 1274 2

Placental site trophoblastic tumor (PSTT) is an uncommon form of gestational trophoblastic disease (GTD) with variable spectrum of clinical behavior. PSTT can occur after a normal pregnancy, spontaneous abortion, termination of pregnancy, ectopic pregnancy or molar pregnancy. Surgery is the primary treatment. Chemotherapy has an established role in loco-regionally advanced and metastatic disease. Many studies indicate that mitotic index is an important prognostic indicator. This article reviews the literature on this rare disease.
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PMID:Placental site trophoblastic tumor. 1283 40


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