Gestational Trophoblastic Disease

Question No. 10. The Answer is: (A) The tumor is usually associated with villi when identified on sections.

Discussion:  Placental site trophoblastic tumors consist of implantation site intermediate trophoblasts that may deeply invade the myometrium. Invasion of blood vessels is often seen as well as extensive fibrinoid deposition. Necrosis and hemorrhage are often seen. While histologic features are not always predictive, certain factors including high mitotic rate, high Ki67, increased cellularity and necrosis are often ominous signs. Key characteristic histologic features include a lack of villi and cytotrophoblasts.

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