An International Journal Clinical Rhinology

Register      Login

VOLUME 10 , ISSUE 3 ( 2017 ) > List of Articles

CASE REPORT

Nasal Metastasis of Placental Site Trophoblastic Tumor: A Rare Case

Bikash L Shrestha, Abha Shrestha

Keywords : Metastasis, Nasal bleeding, Placental site trophoblastic tumor

Citation Information : Shrestha BL, Shrestha A. Nasal Metastasis of Placental Site Trophoblastic Tumor: A Rare Case. Clin Rhinol An Int J 2017; 10 (3):160-162.

DOI: 10.5005/jp-journals-10013-1331

License: CC BY-ND 3.0

Published Online: 01-06-2018

Copyright Statement:  Copyright © 2017; The Author(s).


Abstract

Aim: To present a rare case of placental site trophoblastic tumor (PSTT) metastasis to nasal septum. Study design: Case report. Setting: A tertiary care referral hospital. Case report: A 32-year-old lady multigravida presented with history of intermittent, spontaneous nasal bleeding for 3 days and who had underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy for PSST. Results: Complete excisional biopsy of the left nasal septal mass was performed and sent for the histopathological examination. Grossly, the mass was fleshy, reddish in color, and about 2 × 3 cm in size. Microscopically, there was infiltration of nasal mucosa with the intermediate type trophoblastic cells. After excision of left nasal septal mass, she underwent adjuvant chemoradiation of five cycles and she is in remission phase now. Conclusion: Metastasis of PSST to nasal mucosa is very rare showing placental site trophoblastic cells within nasal mucosa. Though it is rare disease, we have to keep it in differential diagnosis of nasal bleeding.


PDF Share
  1. Muggia, FM.; Eifel, PJ.; Burke, TW. Gestational trophoblastic diseases. In: De Vita VJ, Hellman S, Rosenberg SA, editors. Cancer principles and practice of oncology. 5th ed. Philadelphia (PA): Lippincott-Raven;1997. p. 1427-1539.
  2. Cole ME, Broaddus R, Thaker P, Landen C, Freedman RS. Placental-site trophoblastic tumors: a case of resistant pulmonary metastasis. 2008 Mar;5(3):171-175.
  3. Papadopoulos AJ, Foskett M, Seckl MJ, McNeish I, Paradinas FJ, Rees H, Newlands ES. Twenty-five years’ clinical experience of placental site trophoblastic tumors. J Reprod Med 2002 Jun;47(6):460-464.
  4. Piura B. Placental site trophoblastic tumor is a challenging rare entity. Eur J Gynaecol Oncol 2006;27(6):545-551.
  5. Agarwal N, Parul Kriplani A, Vijayaraghavan M. Placental site trophoblastic tumour. J Postgrad Med [Serial Online] 2002;48:211-212.
  6. Palmieri C, Fisher RA, Sebire NJ, Lindsay I, Smith JR, McCluggage WG, Savage P, Seckl MJ. Placental site trophoblastic tumour arising from a partial hydatidiform mole. Lancet 2005 Aug;366(9486):688.
  7. Hancock BW, Welch EM, Gillespie AM, Newlands ES. A retrospective comparison of current and proposed staging and scoring systems for persistent trophoblastic disease. Int J Gynecol Cancer 2000 Jul;10(4):318-322.
  8. Mukherjee DK. Choriocarcinoma of the nose. Ann Otol Rhinol Laryngol 1978 Mar-Apr;87(2 Pt 1):257-259.
  9. Salimi R. Metastatic choriocarcinoma of the nasal mucosa. J Surg Oncol 1977;9(3):301-5.
  10. Goldberg, B. Clinical tuberculosis. Philadelphia (PA): FA Davis Company Publishers; 1946.
  11. Sharan R. Primary tuberculosis of the nose. Practitioner 1981 Oct; 225(1360):1506-1507.
  12. Agulles Formes MJ, Agut Fuster MA, Grau Mario E, Alario EG. Primary nasal tuberculosis: a forgotten disease? Acta Otolaryngol Esp 2004;55:240-243.
  13. Hyun DW, Ryu JH, Kim YS, Kim KB, Kim WS, Kim CH, Yoon JH. Treatment outcomes of juvenile nasopharyngeal angiofibroma according to surgical approach. Int J Pediatr Otorhinolaryngol 2011 Jan;75(1):69-73.
  14. Hsieh ST, Guo YC, Tsai TL, Chen WY, Huang JL. Angiofibroma of the hypopharynx. J Chin Med Assoc 2004 Jul;67(7): 373-375.
  15. Madana J, Yolmo D, Gopalkrishnan S, Saxena S. Extranasopharyngeal angiofibroma of the cartilaginous nasal septum: possible origin from ectopic tissue trapped during septal development. Internet J Otorhinolaryngol 2012;14(1):1-5.
  16. Dobratz EJ, Tran V, Hilger PA. Comparison of techniques used to support the nasal tip and their long-term effects on tip position. Arch Facial Plast Surg 2010 May-Jun;12(3):172-179.
  17. Friedman O, Koch CA, Smith WR. Functional support of the nasal tip. Facial Plast Surg 2012 Apr;28(2):225-230.
  18. Mohebbi A, Jahandideh H, Faham Z, Jafari M. Defining the best nasal tip projection among Iranian women. Plast Surg Int 2016;2016:8549276.
  19. Bhattacharyya N. Bacterial infection in chronic rhinosinusitis: a controlled paired analysis. Am J Rhinol 2005 Nov- Dec;19(6):544-548.
  20. Boase S, Foreman A, Cleland E, Tan L, Melton-Kroft R, Pant H, Hu FZ, Ehrlich GD, Wormald PJ. The microbiome of chronic rhinosinusitis: culture, molecular diagnostics and biofilm detection. BMC Infect Dis 2013 May;13:210.
  21. Mantovani K, Bisanha AA, Demarco RC, Tamashiro E, Martinez R, Anselmo-Lima WT. Maxillary sinuses microbiology from patients with chronic rhinosinusitis. Braz J Otorhinolaryngol 2010 Sep-Oct;76(5):548-551.
  22. Brook I, Gober AE. Recovery of potential pathogens in the nasopharynx of healthy and otitis media-prone children and their smoking and nonsmoking parents. Ann Otol Rhinol Laryngol 2008 Oct;117(10):727-730.
  23. Wu J, Peters BA, Dominianni C, Zhang Y, Pei Z, Yang L, Ma Y, Purdue MP, Jacobs EJ, Gapstur SM, et al. Cigarette smoking and the oral microbiome in a large study of American adults. ISME J 2016 Mar;10(10):2435-2446.
  24. Ertel A, Eng R, Smith SM. The differential effect of cigarette smoke on the growth of bacteria found in humans. Chest 1991 Sep;100(3):628-630.
  25. Reh DD, Higgins TS, Smith TL. Impact of tobacco smoke on chronic rhinosinusitis: a review of the literature. Int Forum Allergy Rhinol 2012 Sep-Oct;2(5):362-369.
  26. Lee KI, Kim DW, Kim EH, Kim JH, Samivel R, Kwon JE, Ahn JC, Chung YJ, Mo JH. Cigarette smoke promotes eosinophilic inflammation, airway remodeling, and nasal polyps in a murine polyp model. Am J Rhinol Allergy 2014 May-Jun;28(3):208-214.
  27. Kumar PS, Matthews CR, Joshi V, de Jager M, Aspiras M. Tobacco smoking affects bacterial acquisition and colonization in oral biofilms. Infect Immun 2011 Nov;79(11): 4730-4738.
  28. Namiot Z, Namiot DB, Kemona A, Gołebiewska M, Bucki R. The effect of cigarette smoking and alcohol consumption on efficacy of Helicobacter pylori eradication. Pol Arch Med Wewn 2000 Sep;104(3):569-574.
  29. Linder JA, Sim I. Antibiotic treatment of acute bronchitis in smokers: a systematic review. J Gen Intern Med 2002 Mar;17(3):230-234.
  30. Lee WK, Ramanathan M Jr, Spannhake EW, Lane AP. The cigarette smoke component acrolein inhibits expression of the innate immune components IL-8 and human betadefensin 2 by sinonasal epithelial cells. Am J Rhinol 2007 Nov-Dec;21(6):658-663.
  31. Kamath PM, Shenoy VS, Mittal N, Sharma NK. Microbiological analysis of paranasal sinuses in chronic sinusitis—a south Indian coastal study. Egypt J Ear Nose Throat All Sci 2013 Nov;14(3):185-189.
  32. Bezerra TF, Pádna FG, Ogawa AI, Gebrim EM, Saldiva PH, Voegels RL. Biofilms in chronic rhinosinusitis with nasal polyps: pilot study. Braz J Otorhinolaryngol 2009 Nov- Dec;75(6):788-793.
  33. Hashemi M, Sadeghi MMM, Omrani MR, Torabi MA. Microbiology and antimicrobial resistance in chronic resistant rhino sinusitis with or without polyp after functional endoscopic sinus surgery. J Res Med Sci 2005;10(3):167-171.
  34. Farahani F, Youse Mashouf R, Hashemian F, Esmaeili R. Antimicrobial resistance patterns of aerobic organisms in patients with chronic rhinosinusitis in Hamadan, Iran. Avicenna J Clin Microb Infec 2014 Aug;1(2):e18961..
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.