Abstract:

This report presents a case of pulmonary metastasis from placental site trophoblastic tumor (PSTT) treated with chemotherapy combined with thoracoscopic surgery. The patient presented to the Cancer Hospital of Dalian University of Technology (our hospital) with a 15-day history of hemoptysis and elevated human chorionic gonadotropin (hCG) following previous surgery for PSTT. Chest CT revealed multiple solid nodules in both lungs, with the largest located in the left lower lobe. The patient had previously undergone laparoscopic resection of uterine mass, bilateral ovarian cystectomy, and hysteroscopic resection of endometrial lesion at another hospital due to uterine mass, ovarian mass, and intrauterine occupancy. Postoperative pathological examination confirmed PSTT (uterine mass, intrauterine occupancy). After receiving 7 cycles of chemotherapy in our hospital, the patient underwent transabdominal total hysterectomy, bilateral salpingectomy, and bilateral ovarian mass resection under general anesthesia in the gynecology department. A follow-up chest CT five months postoperatively showed enlargement of the left lower lobe nodule compared to the preoperative scan. Subsequently, the patient underwent single-port thoracoscopic left lower lobectomy under general anesthesia in the thoracic surgery department. Postoperative hCG levels were regularly monitored and remained within the normal range through December 2025, and chest CT revealed no significant abnormal nodules.

Key words: Trophoblastic tumor, placental site, Neoplasm metastasis, Antineoplastic combined chemotherapy protocols, Thoracoscopy