Placental Site Trophoblastic Disease: The Basics

Author: Allyson Distel, MPH
Last Reviewed: May 15, 2024

Placental Site Trophoblastic Disease or Tumor (PSTD) is a rare type of Gestational Trophoblastic Disease (GTD). Out of 100 cases of GTD, often 1 or 2 are PSTD. Trophoblasts are cells that are made during the first stage of pregnancy. They provide nutrients for the embryo and become part of the placenta. In PSTD, the trophoblasts form when the placenta attaches to the uterus.

PSTD is different from other types of GTD because it leads to low beta human chorionic gonadotropin (B-hCG). hCG is a hormone in your blood that tells when a woman is pregnant. This level can be low after a normal pregnancy, miscarriage (the loss of a pregnancy), or abortion (ending a pregnancy).

Risk Factors

The risks of PSTD are still being studied. PSTD can happen in women who are of reproductive age and post-menopausal (after they have gone through menopause).

Signs and Symptoms

Some symptoms of PSTD are:

  • Vaginal Bleeding.
  • Amenorrhea (missing one or more menstrual periods).


If you or your provider thinks you have PSTD, they will look at your health history and check your pelvis. You may have imaging tests done such as CT scan, MRI, ultrasound, and x-ray. You may also have your blood and urine tested. The types of surgery mentioned below may be done to tell you if you have PSTD.


The stages of the tumor are 1 to 4 (I to IV). Stage 1 means the disease is only in the uterus and stage 4 means the tumor has spread (metastasized). The stage of your PSTD can help decide what treatment is best for you.

For GTD, a scoring system is used with staging to find out your risk and which treatment is best. PSTD does not use this scoring system.


PSTD is often treated with surgery which helps find, stage, and remove as much of the tumor as possible. Some of the common types of surgery and procedures are:

  • Suction dilation and curettage (also called a “D and C”).
  • Hysterectomy.

A lumbar puncture may be done to see if there are cancer cells in other parts of your body.

Chemotherapy may or may not be used to treat PSTD. Whether chemotherapy is used is based on:

  • If the tumor has spread to areas other than the uterus.
  • If a woman wants to have more children in the future. If this is the case, suction dilation and curettage may be used with chemotherapy.

This article is a basic guide to PSTD. You can learn more about PSTD by visiting:

Surgical Procedures: Surgery and Staging for Placental Site Trophoblastic Disease.

De Nola, R., Schönauer, L. M., Fiore, M. G., Loverro, M., Carriero, C., & Di Naro, E. (2018). Management of placental site trophoblastic tumor: Two case reports. Medicine, 97(48), e13439.

Hashemi, S., Arabipoor, A., Kohestani, S., Zolfaghary, Z., Vesali, S., & Ghaffari, F. (2023). The Predictive Value of Serum ß-HCG Levels in The Detection of Ectopic Pregnancy Sixteen Days after Embryo Transfer: A Cross-Sectional Study. International journal of fertility & sterility, 17(3), 181–186.

Kim S. J. (2003). Placental site trophoblastic tumour. Best practice & research. Clinical obstetrics & gynaecology, 17(6), 969–984.

Nasiri, S., MSc, Sheikh Hasani, S., MSc, Mousavi, A., MSc, Modarres Gilani, M., MSc, Akhavan, S., MSc, & Vakili, M. R., MSc (2018). Placenta Site Trophoblastic Tumor and Choriocarcinoma from Previous Cesarean Section Scar: Case Reports. Iranian journal of medical sciences, 43(4), 426–431.

National Cancer Institute (2022). Gestational Trophoblastic Disease Treatment. 

National Institutes of Health (2017). Amenorrhea.

Niknejadi, M., Ahmadi, F., & Akhbari, F. (2016). Imaging and Clinical Data of Placental Site Trophoblastic Tumor: A Case Report. Iranian journal of radiology : a quarterly journal published by the Iranian Radiological Society, 13(2), e18480.

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