Treatment of metastatic placental site trophoblastic tumor with surgery, chemotherapy, immunotherapy and coil embolization of multiple pulmonary arteriovenous fistulate

A. Porter; J.M. Barcelon; R.L. Budker; L. Marsh; J.M. Moriarty; X. Aguiar; J. Rao; E. Ghorani; B. Kaur; G. Maher; M.J. Seckl; G.E. Konecny; J.G. Cohen

Gynecologic Oncology Reports (May 2021)

Treatment of metastatic placental site trophoblastic tumor with surgery, chemotherapy, immunotherapy and coil embolization of multiple pulmonary arteriovenous fistulate

A. Porter,
J.M. Barcelon,
R.L. Budker,
L. Marsh,
J.M. Moriarty,
X. Aguiar,
J. Rao,
E. Ghorani,
B. Kaur,
G. Maher,
M.J. Seckl,
G.E. Konecny,
J.G. Cohen

Affiliations

A. Porter: University of California Los Angeles, Division of Hematology Oncology, Los Angeles, CA, USA
J.M. Barcelon: University of California Los Angeles, Division of Gynecologic Oncology, Los Angeles, CA, USA
R.L. Budker: University of California Los Angeles, Division of Gynecologic Oncology, Los Angeles, CA, USA
L. Marsh: University of California Los Angeles, Division of Gynecologic Oncology, Los Angeles, CA, USA
J.M. Moriarty: University of California Los Angeles, Division of Interventional Radiology, Los Angeles, CA, USA
X. Aguiar: California Los Angeles, Department of Pathology, Los Angeles, CA, USA
J. Rao: California Los Angeles, Department of Pathology, Los Angeles, CA, USA
E. Ghorani: Gestational Trophoblastic Disease Centre, Charing Cross Hospital Campus of Imperial College London, United Kingdom
B. Kaur: Gestational Trophoblastic Disease Centre, Charing Cross Hospital Campus of Imperial College London, United Kingdom
G. Maher: Gestational Trophoblastic Disease Centre, Charing Cross Hospital Campus of Imperial College London, United Kingdom
M.J. Seckl: Gestational Trophoblastic Disease Centre, Charing Cross Hospital Campus of Imperial College London, United Kingdom
G.E. Konecny: University of California Los Angeles, Division of Hematology Oncology, Los Angeles, CA, USA; Corresponding author.at: 100 Medical Plaza, Suite 550, University of California Los Angeles, Los Angeles, CA 90095.
J.G. Cohen: University of California Los Angeles, Division of Gynecologic Oncology, Los Angeles, CA, USA

Journal volume & issue: Vol. 36
p. 100782

Abstract

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Placental Site Trophoblastic Tumor (PSTT) is a rare malignancy that often presents with extensive disease and can be resistant to traditional treatments. We present the case of a woman with stage IV PSTT who was initially managed with neoadjuvant chemotherapy followed by tumor debulking. Adjuvant therapy was guided by further pathologic analysis that revealed high levels of staining for PD-L1 as well as the presence of tumor infiltrating lymphocytes (TILs). Subsequently, the patient was treated with traditional chemotherapy with the EP/EMA regimen with the addition of pembrolizumab. The patient’s treatment course was complicated by the development of pulmonary arteriovenous malformations, autoimmune thyroiditis thought to be secondary to immunotherapy, and significant tinnitus secondary to platinum agents. Currently the patient is in follow up and remains in a complete remission.

Published in Gynecologic Oncology Reports

ISSN: 2352-5789 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Gynecology and obstetrics; Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: http://www.journals.elsevier.com/gynecologic-oncology-reports/

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Abstract

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