RT Journal Article SR Electronic T1 Placental site trophoblastic tumor presenting with scalp metastases JF International Journal of Gynecologic Cancer JO Int J Gynecol Cancer FD BMJ Publishing Group Ltd SP 333 OP 336 DO 10.1136/ijgc-00009577-199607000-00016 VO 6 IS 4 A1 E.M. Hartenbach A1 A.K. Saltzman A1 C. B. Zachary A1 J.L. Osborne A1 T. Okagaki A1 L.B. Twiggs YR 1996 UL http://ijgc.bmj.com/content/6/4/333.abstract AB 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.