[Uterine perforation revealing a rare placental tumor: trophoblastic tumor of the implantation site. Review of the literature. Apropos of a case]

Abstract

The trophoblastic tumor of the implantation site (TTIS), recently discovered, is a peculiar and rare choriocarcinoma; the authors are reporting the 36th case in the world. Clinically, it is different from the typical choriocarcinoma by amenorrhea, frequent uterine perforations and negative pregnancy tests. The diagnosis is made histologically; most important are the monomorphic tumor cells, and especially, the immunocytochemical labelling for human chorionic gonadotropic hormone and lactogenic placental hormone permitting the differentiation of TTIS in choriocarcinoma from TTIS in non-trophoblastic tumors. Its course is highly malignant in 25 p. cent of the cases without any absolute prognostic factor at this time. The treatment is not codified; it seems that, unlike in the typical choriocarcinoma, a place of choice should be given to surgery, since the usual chemotherapy of trophoblastic tumors has not proved to be effective in this indication. On the contrary, monitoring will be supported by serum hCG assays.