AI Article Synopsis
- - Placental site trophoblastic disease (PSTT) and epithelioid trophoblastic tumor (ETT) are rare types of gestational trophoblastic neoplasia (GTN) that present distinct clinical features and treatment approaches, notably without significantly elevated human chorionic gonadotropin (hCG) levels.
- - Management typically involves surgery, such as hysterectomy, and lymph node removal; there are some cases where fertility-sparing surgeries have been performed for localized disease.
- - While early-stage, low-risk cases show good survival rates, high-risk patients, especially those with advanced disease or post-48 months from previous pregnancies, have a poor prognosis and require new treatment options.
Article Abstract
Placental site trophoblastic disease (PSTT) and epithelioid trophoblastic tumor (ETT) are the rarest forms of gestational trophoblastic neoplasia (GTN) with unique clinical features and treatment considerations. Unlike other GTN, human chorionic gonadotropin (hCG) is minimally, if at all, elevated. Additionally, unlike other GTN, WHO risk scores are not applied to PSTT/ETT. Management of PSTT/ETT is predominately surgical with hysterectomy and possible lymphadenectomy. There are case reports of fertility sparing surgery for uterine confined disease. Multi-agent chemotherapy ± pembrolizumab is added for those with high risk features defined as advanced stage disease and those diagnosed ≥48 months from the antecedent pregnancy. Survival for early stage, low risk disease remains quite good but the prognosis for high-risk disease is poor and an scenario for which novel treatments are needed.
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| http://dx.doi.org/10.1016/j.hoc.2024.08.016 | DOI Listing |
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