October 2017 · Volume 6 · Issue 10 Page 4711 International Journal of Reproduction, Contraception, Obstetrics and Gynecology Patel MU et al. Int J Reprod Contracept Obstet Gynecol. 2017 Oct;6(10):4711-4714 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 Case Report Malignant placental trophoblastic tumour a diagnostic dilemma: rare association with focal segmental glomerulonephritis and cardiomyopathy Molina U. Patel*, Chetna S. Vyas, Smruti B. Vaishnav INTRODUCTION Placental site trophoblastic tumor (PSTT) is a rare form of gestational trophoblastic disease arising from invasive intermediate gestational trophoblasts and constitutes 1 to 2% of all GTN. 1 It was considered a benign lesion until Scully and Young recognized its malignant potential in 1981. 2 Due to its relatively slow lymphatic spread and chemo resistant nature, metastatic lesions to brain or kidneys often pose a diagnostic dilemma. The association of PSTT with kidney diseases is very rare. World over, there are only a handful of cases which report its association with Lupus Nephritis, thrombotic microangiopathy (TMA) membranous glomerulonephritis. 3 However, here we report one of first few cases of PSTT associated with focal segmental GN. CASE REPORT A 20 year old female presented with 2 months amenorrhea with complain of lower abdominal pain since 20 days. She has Full term vaginal delivery one and half year back after which she had resumed her regular menses. UPT done was positive and USG showed changes of Vesicular Mole with multiple uterine fibroids. However, her B HCG was only 179.3 IU/L which was very low to support any intrauterine or molar pregnancy. Her pelvic examination was normal and routine lab tests showed only hypoproteinemia, Mild anaemia and mildly raised ESR. Clinically, she had minimal ascites. Dilatation and Evacuation was done. Thereafter B HCG value was 129.6 IU/L. Histopathological diagnosis revealed placental Site reaction. ABSTRACT Placental site trophoblastic tumour (PSTT) is the rarest form of Gestational trophoblastic neoplasia (GTN).It has a wide clinical spectrum of presentation and its complications have a multi organ involvment. Inspite of the advances in HCG assays and sensitive unltrasounds, its diagnosis and course in every case is a mystery. However, it is only rarely associated with glomerulonephritis. Most cases have not been biopsied and the specific nature of renal involvement is not clearly understood. Here we report a case of PSTT with glomerulonephritis and cardiomyopathy. Keywords: Placental site trophoblastic tumor, Glomerulonephritis (GN), Gestational trophoblastic neoplasia, Trophoblastic neoplasia Department of Obstetrics and Gynecology, Shree Krishna hospital and HM Patel Centre for higher Education, Karamsad, Gujarat, India Received: 20 July 2017 Accepted: 18 August 2017 *Correspondence: Dr. Molina U. Patel, E-mail: drmolinapatel@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20174471