PLACENTAL SITE TROPHOBLASTIC TUMOR PRESENTING WITH SCALP METASTASES

Placental site trophoblastic tumor (PSTT) usually presents with vagina l bleeding or amenorrhea and an enlarged uterus. Metastasis to the ski n as the presenting sign, or as a metastatic site, has not been previo usly reported with PSTT. We report a case of PSTT in which the present ing sign was scalp metastases and the only other disease was a small f ocus in the uterus. The patient responded to multi-agent chemotherapy and repeated skin resection at the local site. She received 16 alterna ting cycles of etoposide-methotrexate-actinomycin D and cytoxan-oncovi n (EMA/CO) and is currently without evidence of disease. Clinicians ca ring for reproductive age women should remain aware that gestational t rophoblastic disease (GTD) may present in an unusual manner.