EP22.18: Placental site trophoblastic tumour

Placental site trophoblastic tumour (PSTT) is a rare form of gestational trophoblastic disease that secretes B-HCG, has a metastatic potential and is resistant to several chemotherapy regimens. This entity has a heterogenous clinical presentation posing difficulty in early diagnosis. This study shows 5 cases of PSTT with varying clinical presentation highlighting the importance of clinical suspicion in early diagnosis. All the women in this study had a previous history of spontaneous miscarriage (D&C not done). The B-BCG levels very high to low in all cases. Clinical presentation was abnormal uterine bleeding either slight, heavy or intermittent or amenorrhea. All the patients were scanned on the GE Voluson E8 machine using transvaginal 3D ultrasound with colour Doppler. MRI was done in one patient and histopathological confirmation was done in all cases. Patients were subjected to surgery with a frozen section. Ultrasound showed an ill defined echogenic mass in the endometrial cavity with or without vascularity in the early stage, later stages showed myometrial extension and vascularity. Cases were diagnosed based on ultrasound findings leading to further work-up, underwent hysterectomy with a favourable outcome. Ultrasound is the first line investigation in bleeding disorders. In the lower economic section of women of India, failed gestations without D&C is very common and this as a predisposing factor, knowledge of ultrasound features and suspicion of this rare entity is important for early diagnosis. B-HCG and histopathological confirmation is mandatory. 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.