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Here, we experienced 4 cases of placental site trophoblastic tumor (PSTT) that produced immunoglobulin (Ig). Three cases showed recurrence and responded well to pembrolizumab therapy. Among them, we could analyze temporal changes in the genetic profiles on one case of daughter\u2010derived PSTT, which relapsed after pembrolizumab therapy. In this case, we found that PSTT incorporated the exogenous genes from host maternal cells. The rearrangement patterns of Ig genes and protein expressions sequentially increased. By analyzing single\u2010nucleotide variants, PSTT incorporated daughter\u2010non\u2010inherited maternal alleles (DNIMA), including the Ig lambda and HLA\u2010DQA2 loci. Protein expressions of TLR10 and SIGLEC10 increased during tumor progression concomitantly with DNIMA incorporation. DNIMA mapping indicates the incorporation of exogenous maternal genes was widely distributed through the whole chromosomes, suggesting the involvement of cell fusion in gene transfer mechanisms. These findings indicate that PSTT sequentially incorporated exogenous genes from maternal cells to express immune\u2010related molecules and suggest that cancer cells acquired B cell\u2010related functions, including Ig production by cell fusion with host immune cells.<\/jats:p>","DOI":"10.1002\/advs.76071","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T06:47:51Z","timestamp":1782283671000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Placental Site Trophoblastic Tumor Acquires Immune Functions by Incorporating Host Maternal Genes"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3357-0914","authenticated-orcid":false,"given":"Kyosuke","family":"Kagami","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Graduate School of Medical Sciences Kanazawa University  Kanazawa 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University Graduate School of Medicine  Kyoto Japan"},{"name":"Department of Obstetrics and Gynecology Medical Research Institute KITANO HOSPITAL  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5800-6769","authenticated-orcid":false,"given":"Sachiko","family":"Minamiguchi","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology Fujita Health University School of Medicine  Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoko","family":"Fujiwara","sequence":"additional","affiliation":[{"name":"Department of Human Life Environments Kyoto Notre Dame University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuyoshi","family":"Hosomichi","sequence":"additional","affiliation":[{"name":"Laboratory of Computational Genomics School of Life Science Tokyo University of Pharmacy and Life Sciences  Hachioji Tokyo Japan"},{"name":"Department of 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