Transformation of a post-cesarean section placental site nodule into a coexisting epithelioid trophoblastic tumor and placental site trophoblastic tumor: a case report
1 Deparment of Pathology, Taipei Medical University Hospital, Taipei, Taiwan
2 Department of Pathology, School of Medicine, College of Medicine, Taipei Medical University, 250 Wu-Hsing St, Taipei 11031, Taiwan
3 Department of Pathology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
Diagnostic Pathology 2013, 8:85 doi:10.1186/1746-1596-8-85Published: 20 May 2013
Placental site nodules (PSNs) and epithelioid trophoblastic tumors (ETTs) respectively represent non-neoplastic and neoplastic lesions of chorionic-type intermediate trophoblasts (ITs). Many patients with a PSN have a history of a cesarean section (CS) or therapeutic abortion. Recent evidence shows that a PSN may progress to an ETT. Herein, we describe a coexisting ETT and placental site trophoblastic tumor (PSTT) intimately associated with PSNs in the post-cesarean lower uterine segment of a 41-year-old woman. The patient presented with abnormal vaginal bleeding 1 year after a cesarean delivery for her most recent pregnancy. We speculated that the neoplasms had transformed from PSNs, the formation of which was related to faulty expulsion of the placental tissue or abnormal colonization of chorionic-type ITs during the CS. Neoplastic trophoblastic cells derived from PSNs displayed differentiation plasticity toward chorionic-type ITs and implantation site ITs that were respectively constituted of an ETT and PSTT.
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