Placental site trophoblastic tumor (PSTT) is a rare form of gestational trophoblastic neoplasia with unclear risk factors. The nonspecific and uncharacteristic clinical and biochemical presentation and the rarity of these malignancies makes the diagnosis of PSTT often difficult thereby leading to a low preoperative diagnosis. Here, we report a case of PSTT with nonspecific and uncharacteristic behavior leading to dilemma in diagnosis and who also had vascular tumor emboli on histopathological examination. She was treated with hysterectomy for PSTT, and subsequently developed an occult isolated CNS metastasis for which she received 6 cycles of EMA/EP chemotherapy. At the latest follow-up, the patient's course was satisfactory, and she exhibited no signs of tumor recurrence. The rarity, uncharacteristic behavior and its successful outcome in management mandates this case to be reported.
Key words: Placental site trophoblastic tumor (PSTT), Gestational trophoblastic disease (GTD), chemotherapy, Immunochemistry