背景:胎盘部位结节(PSN)是由绒毛膜型中间滋养细胞形成的良性肿瘤样生长。其临床意义未知。本研究旨在确定与PSN相关的风险因素,关注可能的生殖影响。
方法:我们在2018年至2022年的大型城市医院系统中对所有病理诊断为PSN的患者进行了回顾性病例系列。我们收集了临床变量,如病理诊断/描述,出现症状,事先交货的方法,和以前的不孕史,怀孕失败,和子宫器械。
结果:本病例系列共纳入32例患者。最常见的症状是异常子宫出血(40.6%,13/32)。复发性妊娠丢失(RPL)(15.6%,5/32)和不孕症(15.6%,5/32)也是常见的症状。62.5%(20/32)的患者有既往子宫器械史。9.4%(3/32)的病例同时存在慢性子宫内膜炎。在5例接受PSN宫腔镜切除术的RPL/不孕症患者中,1实现了活产。
结论:PSNs可能与异常子宫出血有关,反复妊娠丢失,不孕症,既往子宫器械史,和慢性子宫内膜炎。虽然是罕见的诊断,出现不孕症或复发性失孕体检的患者应考虑PSN的存在.
BACKGROUND: Placental site nodules (PSNs) are benign tumor-like growths that develop from chorionic-type intermediate trophoblastic cells. Their clinical significance is unknown. This study aims to determine the risk factors associated with PSNs, with focus on possible reproductive impact.
METHODS: We performed a retrospective
case series of all patients with a pathology diagnosis of PSN in a large urban hospital system from 2018 to 2022. We collected clinical variables such as pathology diagnosis/description, presenting symptoms, method of prior delivery, and prior history of infertility, pregnancy loss, and uterine instrumentation.
RESULTS: A total of 32 patients were included in this
case series. The most common presenting symptom was abnormal uterine bleeding (40.6%, 13/32). Recurrent pregnancy loss (RPL) (15.6%, 5/32) and infertility (15.6%, 5/32) were common presenting symptoms as well. 62.5% (20/32) patients had a history of prior uterine instrumentation. Coexisting chronic endometritis was identified in 9.4% (3/32) of cases. Of the 5 RPL/infertility patients who underwent hysteroscopic resection of a PSN, 1 achieved a live birth.
CONCLUSIONS: PSNs may be associated with abnormal uterine bleeding, recurrent pregnancy loss, infertility, history of prior uterine instrumentation, and chronic endometritis. Although a rare diagnosis, the presence of a PSN should be considered in patients presenting for infertility or recurrent pregnancy loss workup.