A Rare Case of Placental Site Trophoblastic Tumor

Placental site trophoblastic tumor (PSTT) is a rare entity of malignant gestational trophoblastic neoplasia (GTN) with an incidence of 0.23 to 3% of all gestational trophoblastic diseases (GTD). They originate from intermediate trophoblastic cells of the placenta. They are slow-growing tumors and less chemo sensitive. Per vaginal bleeding following a miscarriage is not uncommon, however malignant variants of gestational trophoblastic neoplasia also could be a possibility. We are reporting a 24-year-old who was an otherwise healthy female who presented with persistent per vaginal bleeding following the first-trimester miscarriage in her second pregnancy. Initial histology of suction evacuation for her miscarriage has shown a partial mole. Since she continues to have per vaginal bleeding even a month later, repeat evacuation was done and beta hCG was high (2132mIU/ml), she was treated with a methotrexate regime. During follow up there was a slow rising of beta hCG level and hysterectomy was carried out due to the suspicions of invasive mole or PSTT. Histology confirmed a placental site trophoblastic tumor and her recovery and follow-up were uneventful.