Article Text

Placental site trophoblastic tumor presenting with scalp metastases
  1. E.M. Hartenbach*,
  2. A.K. Saltzman*,
  3. C. B. Zachary,
  4. J.L. Osborne*,
  5. T. Okagaki*, and
  6. L.B. Twiggs*
  1. Departments of *Obstetrics and Gynecology, †Dermatology,‡Laboratory Medicine and Pathology, Women's Cancer Center, University of Minnesota, Box 395 UMHC, 420 Delaware Street Southeast, Minneapolis, MN 55455, USA
  1. Address for correspondence: Dr E. M. Hartenbach, Assistant Professor, UW Hospitals & Clinics, Room H4/636, 600 Highland Ave., Madison, WI 53792, USA.

Abstract

Placental site trophoblastic tumor (PSTT) usually presents with vaginal bleeding or amenorrhea and an enlarged uterus. Metastasis to the skin as the presenting sign, or as a metastatic site, has not been previously reported with PSTT. We report a case of PSTT in which the presenting sign was scalp metastases and the only other disease was a small focus in the uterus. The patient responded to multi-agent chemotherapy and repeated skin resection at the local site. She received 16 alternating cycles of etoposide-methotrexate-actinomycin D and cytoxan-oncovin (EMA/CO) and is currently without evidence of disease. Clinicians caring for reproductive age women should remain aware that gestational trophoblastic disease (GTD) may present in an unusual manner.

  • placental site tumor
  • trophoblastic disease

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