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Edited by Ie-Ming Shih, MD, PhD
Division of Gynecologic Pathology
Department of Pathology
Johns Hopkins Medical Institutions
E-mail: ishih@jhmi.edu
Tel: (410) 502-7774
1503 E. Jefferson Street, B-315
Baltimore, MD 21231
Lab website: http://pathology2.jhu.edu/shihlab
Special thanks to Dr. Chih-Yi Hsu for his efforts in photomicrographs and legends
Webmaster; Jennifer Parsons Brumbaugh
Diagnostic pathologists in Gynecological Pathology Division
at the Johns Hopkins Hospital:
Robert J. Kurman, MD, Director
Brigitte Ronnett, MD
Ie-Ming Shih, MD, PhD
Russell Vang, MD
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Placental site trophoblastic tumor (PSTT)
Clinical features:
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Neoplasm of implantation site IT
- Reproductive ages
- antecedent pregnancy can be remote
- b-HCG only mildly increased
- Most are benign, ~20% are malignant
- Treatment: hysterectomy or local excision
Gross appearance:
- Well circumscribed lesion
- Involving myometrium
- Soft and tan in color
- Focal hemorrhage and necrosis
Solid sheets/masses
confluent growth of
Implantation site IT
No chorionic villi
Blood vessels preserved
Sheets of trophoblastic cells
vessel walls replaced by fibrinoid material and trophoblastic cells
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