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Journals / Türk Jinekolojik Onkoloji Dergisi / 2026 / Cilt: 26 Sayı: 2

Atypical Placental Site Nodule Arising in an Isthmocele: Case Report and Review of the Literature

İstmoselde Gelişen Atipik Plasental Site Nodül: Olgu Sunumu ve Literatür Derlemesi

Fatma Ceren Güner(AKDENİZ ÜNİVERSİTESİ)0000-0001-8654-7426
Saliha Sağnıç(AKDENİZ ÜNİVERSİTESİ, TIP FAKÜLTESİ)
Elif Iltar(AKDENİZ ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0002-8612-7533
Selen Dogan(AKDENİZ ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0002-4019-5581
Pages
80–85
Publication Date
2026-09-30
DOI
—
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

She was diagnosed with APSN because her Ki-67 index was higher than PSN and lower than PSST / ETT and larger tumor size.This case underscores the importance of considering APSN in the differential diagnosis of chronic pelvic pain and oligomenorrhea post pregnancy, highlighting the need for early recognition and appropriate management to prevent progression to more severe trophoblastic tumors such as placental site trophoblastic tumor (PSTT) or epithelioid trophoblastic tumor (ETT).

📌 3 Key Takeaways

🎯
Objective & Hypothesis:A 42-year-old woman presented with chronic pelvic pain and oligomenorrhea 20 months after her last pregnancy.
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Key Findings & Data:Subsequent isthmocele repair and histopathological examination our patient had GATA3, P 63, and PLAP positivity, HPL, and MCAM negativity, and the Ki-67 index was 5-10%.
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Conclusion & Impact:She was diagnosed with APSN because her Ki-67 index was higher than PSN and lower than PSST / ETT and larger tumor size.This case underscores the importance of considering APSN in the differential diagnosis of chronic pelvic pain and oligomenorrhea post pregnancy, highlighting the need for early recognition and appropriate management to prevent progression to more severe trophoblastic tumors such as placental site trophoblastic tumor (PSTT) or epithelioid trophoblastic tumor (ETT).
🔬Design:Olgu Sunumu
📍Scope:Comprehensive Sample
⚙️Variables:Atipik Plasental Site Nodül · intermediate trofoblastik tümör · İstmosel

Abstract

A 42-year-old woman presented with chronic pelvic pain and oligomenorrhea 20 months after her last pregnancy. MRI revealed a cesarean section scar and a large isthmocele causing a complete myometrial defect. Subsequent isthmocele repair and histopathological examination our patient had GATA3, P 63, and PLAP positivity, HPL, and MCAM negativity, and the Ki-67 index was 5-10%. She was diagnosed with APSN because her Ki-67 index was higher than PSN and lower than PSST / ETT and larger tumor size.This case underscores the importance of considering APSN in the differential diagnosis of chronic pelvic pain and oligomenorrhea post pregnancy, highlighting the need for early recognition and appropriate management to prevent progression to more severe trophoblastic tumors such as placental site trophoblastic tumor (PSTT) or epithelioid trophoblastic tumor (ETT).

Özet

42 yaş kadın hasta, doğumdan 20 ay sonra kronik pelvik ağrı ve oligomenore şikayetleri ile başvurdu. MRG’de, sezaryen skarı ile uyumlu alanda tam kat miyometrial defekte yol açan büyük bir istmosel tespit edildi. Yapılan cerrahi onarım sonrası istmosel kesesinin histopatolojik incelemesinde hastamızda GATA3, P63 ve PLAP pozitifliği, hPL ve MCAM negatifliği saptandı ve Ki-67 indeksi %5–10 olarak bulundu. Hastaya, Ki-67 indeksinin PSN’den daha yüksek, PSST/ETT’den ise daha düşük olması ve tümör boyutunun daha büyük olması nedeniyle APSN tanısı konuldu. Bu vaka, gebelik sonrası kronik pelvik ağrı ve oligomenorenin ayırıcı tanısında APSN’nin göz önünde bulundurulması gerektiğini vurgulamakta olup, erken tanı ve uygun tedavinin, plasental site trofoblastik tümörü (PSTT) veya epiteloid trofoblastik tümör (ETT) gibi daha agresif trofoblastik tümörlere ilerlemeyi önlemedeki kritik rolüne dikkat çekmektedir.

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Cite This Article

Güner, F. C., Sağnıç, S., Iltar, E., Dogan, S. (2026). Atypical Placental Site Nodule Arising in an Isthmocele: Case Report and Review of the Literature. Türk Jinekolojik Onkoloji Dergisi, Cilt: 26 Sayı: 2, 80–85. https://ajindex.com/articles/1602981

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