J Lung Cancer.  2009 Dec;8(2):114-117. 10.6058/jlc.2009.8.2.114.

Epitheilioid Trophoblastic Tumor of the Lung: A Case Report

• Ha SY
• Cho HY
• Lee JI

• KMID: 2199972
• DOI: http://doi.org/10.6058/jlc.2009.8.2.114

Abstract

Epithelioid trophoblastic tumor is a rare type of gestational trophoblastic disease that is distinct from placental site trophoblastic tumor and choriocarcinoma, and epithelioid trophoblastic tumor has features resembling a carcinoma. We report here on an epithelioid trophoblastic tumor that was discovered as a solitary pulmonary nodule in the lung of a 50-year-old woman. The patient had suffered from a hydatidiform mole 20 years previously. Wedge resection of the lung was done and this showed a 1.9x1.5 cm sized, relatively well defined mass composed of mononuclear tumor cells admixed with hyaline-like material and necrosis. The tumor cells were positive for EMA, Cam5.2, alpha-inhibin, PLAP and hCG. After consulting the gynecologic department, a 7.5x6.5 cm sized mass was discovered in the uterine fundus. Hysterectomy was then done. The tumor cells were same to those of the lung mass. The lung mass is considered to be metastasis from the epithelioid trophoblastic tumor of the uterus. She has been an uneventful clinical course for three years.

Keyword

Lung; Trophoblastic neoplasms; Metastasis; Gestational trophoblastic neoplasms

MeSH Terms

Biomarkers
Choriocarcinoma
Female
Gestational Trophoblastic Disease
Humans
Hydatidiform Mole
Hysterectomy
Inhibins
Keratins
Lung
Middle Aged
Necrosis
Neoplasm Metastasis
Pregnancy
Solitary Pulmonary Nodule
Trophoblastic Neoplasms
Trophoblastic Tumor, Placental Site
Trophoblasts
Uterus
Inhibins
Keratins

Figure

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  Fig. 1. Chest CT showed a focal consolidating lesion with central calcification in the right middle lobe.

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  Fig. 2. Grossly, there was an ovoid yellowish white mass with necrosis and whitish calcification. It was not connected with the bronchus.

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  Fig. 3. Histological findings for the lung mass (A, B). The low power view showed nests of atypical cells with necrosis and multifocal calcification (A, H&E stain, ×40). The tumor cells were mononucleate trophoblasts admixed with dense eosinophilic material (B, H&E stain, ×200). The histological findings for the mass in the uterus (C, D). Microscopically, there was massive necrosis and a solid mass of atypical cells (C, H&E stain, ×40). The tumor showed infiltrating nests of cells surrounded by dense hyaline material (D, H&E stain, ×200).

Reference

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