Abstract
We report an uncommon clinical presentation of a placental site trophoblastic tumor. The patient presented initially with abdominal pain with, fever, bleeding and pelvic mass on ultrasonography leading to the wrong diagnosis of a pelvic abscess. Dilation and curettage were performed and pathological examination confirmed the diagnosis. of placental site trophoblastic tumor. Therefore, she underwent abdominal hysterectomy. Four years after surgery, the patient is still disease free. Gestational trophoblastic diseases should be considered in every patient presenting abnormal uterine bleeding after delivery or pregnancy loss despite the associated symptoms being very unusual.
Highlights
We report a case of placental site trophoblastic tumor diagnosed by an array of pelvic abscess associated with bleeding occurring two months after delivery
Pathological examination of the endometrial curettage specimen reported a proliferation of large tumor cell with eosinophilic cytoplasm and nuclear atypia, infiltrating the myometrium
These cells were positive for pro inflammatory cytokine (IL6) in the immunohistochemistry studies and the final diagnosis was a placental site trophoblastic tumor
Summary
Placental site trophoblastic tumor (PSTT) is a rare tumor, representing 1% of gestational trophoblastic diseases.[1,2] It mainly affects women of childbearing age after delivery or pregnancy loss.[1,2,3] In this paper, we report a case of placental site trophoblastic tumor diagnosed by an array of pelvic abscess associated with bleeding occurring two months after delivery. The transvaginal sonography showed a large sized uterus containing an echogenic heterogeneous endometrial mass, vascularized on Doppler examination. This process seemed to invade the myometrium in part. Pathological examination of the endometrial curettage specimen reported a proliferation of large tumor cell with eosinophilic cytoplasm and nuclear atypia, infiltrating the myometrium. These cells were positive for pro inflammatory cytokine (IL6) in the immunohistochemistry studies and the final diagnosis was a placental site trophoblastic tumor.
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