ArticleFrontiers in oncology2026
Successful delivery after fertility-sparing surgery for stage I placental site trophoblastic tumor: a rare case report.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Placental site trophoblastic tumor (PSTT) is a rare subtype of gestational trophoblastic neoplasia (GTN) characterized by relative chemoresistance. The primary recommended treatment, especially for non-metastatic disease, is hysterectomy, making fertility-sparing a significant clinical challenge. There are exceedingly few reported cases of successful uterine preservation, highlighting the need for well-documented management strategies for early-stage patients with a strong desire for future fertility. Case presentation: We report the case of a 32-year-old woman (gravida 0, para 0) diagnosed with stage I PSTT, who initially presented with post-amenorrheic vaginal bleeding and fluctuating serum beta-human chorionic gonadotropin (β-hCG) levels and was initially misdiagnosed with an ectopic pregnancy. After unsuccessful methotrexate therapy, pelvic magnetic resonance imaging (MRI) accurately identified a focal myometrial lesion, leading to the correct diagnosis. Guided by multidisciplinary assessment and the patient's fertility desire, fertility-sparing management involving precise resection of the myometrial lesion followed by adjuvant actinomycin D/cyclophosphamide and vincristine (EMA/CO) chemotherapy was implemented to minimize recurrence risk. Following rigorous surveillance, the patient successfully conceived, delivered a healthy infant, and remained disease-free with negative β-hCG, ultrasound, and MRI findings at the 42-day postpartum check-up. Conclusion: This case highlights the value of pelvic MRI in facilitating the diagnosis of PSTT and suggests that fertility-sparing surgery combined with adjuvant chemotherapy may be a feasible treatment option for carefully selected patients with stage I PSTT who desire future fertility.
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