EP29.13: The role of uterine artery pulsatility index and a new ultrasound‐guided approach to uterine biopsy in the preoperative evaluation of placental site trophoblastic tumour

Abstract

Hysterectomy is the therapy of Placental Site Trophoblastic Tumour (PSTT) without metastatic spreading. Pre-operative histological diagnosis may not available due to localisation into deep myometrium. The trans-vaginal ultrasonography (TV-US) findings of PSTT are not supportive for differential diagnosis with choriocarcinona (CC). Therefore, the pre-surgical diagnosis of PSTT is often challenging. The aim is to illustrate the behaviour of uterine artery pulsatility index (UAPI) in the ultrasound evaluation of PSTT and to show a new approach to obtain histological diagnosis. Among 345 patients affected by gestational trophoblastic tumour, three cases of suspected PSTT were recorded. They underwent TV-US with uterine artery Doppler velocimetry performed by an expert operator. TV-US identified uterine nodules in all patients whereas UAPI showed a high resistance flow pattern in all patients (mean PI patient#1: 2.25;patient#2: 3.5;patient #: 3.9) in contrast with UAPI generally recorded in CC (figure 1). Moreover, we reported the first case of laparoscopic uterine biopsy under ultrasound guidance to obtain histological diagnosis before hysterectomy. Supporting information can be found in the online version of this abstract Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.