Obstet Gynecol Sci.  2017 Jan;60(1):124-128. 10.5468/ogs.2017.60.1.124.

Extrauterine epithelioid trophoblastic tumor in hysterectomized woman

• Kim JH
• Lee SK
• Hwang SH
• Kim JS
• Yoon G
• Lee YY
• Kim TJ
• Choi CH
• Kim BG
• Bae DS
• Lee JW

• KMID: 2383220
• DOI: http://doi.org/10.5468/ogs.2017.60.1.124

Abstract

Epithelioid trophoblastic tumor (ETT) is a very rare variant of gestational trophoblastic disease (GTD) which arises in reproductive age women with prior gestational history. Although abnormal vaginal bleeding is the most common symptom of ETT, there are no reported pathognomonic symptoms of ETT because of its rarity. ETT is similar to placental site trophoblastic tumor in terms of its slow growing characteristic and microscopic findings. Therefore, it could be misdiagnosed as placental site trophoblastic tumor or other types of GTD. Unlike other types of GTD, primary treatment of ETT is surgical resection because of its chemo-resistant nature. Accordingly, immunohistochemical staining is essential for accurate diagnosis and appropriate treatment. Here, we report a case of a 42-year-old hysterectomized woman with pelvic masses who suffered from abdominal pain. Through laparotomy, tumors were resected completely and they were diagnosed as ETT through immunohistochemical stain. This report provides more evidence about its clinical features, diagnosis, and treatment including a brief review of the literature.

Keyword

Beta human chorionic gonadotropin; Epithelioid trophoblastic tumor; Gestational trophoblastic disease

MeSH Terms

Abdominal Pain
Adult
Diagnosis
Female
Gestational Trophoblastic Disease
Humans
Laparotomy
Trophoblastic Neoplasms*
Trophoblastic Tumor, Placental Site
Trophoblasts*
Uterine Hemorrhage

Figure

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  Fig. 1 Magnetic resonance imaging findings and pathologic evaluations of our patient. (A) Gross finding, midline lower abdominal wall mass with rectus abdominis muscle (photo during operation). (B,C) About 9-cm-sized midline lower abdominal wall soft tissue lesion with low signal intensity in T2W1 image on magnetic resonance imaging (arrowed). (B) Sagittal view and (C) transverse view. (D) The tumor was composed of nests of epithelioid cells with necrotic debris and peritumoral hyaline-like material (H&E, ×20). (E) Positive cytoplasmic staining for β-human chorionic gonadotropin (×100). (F) Positive cytoplasmic staining for inhibin-α (×100). (G) Positive nuclear staining for p63 (×100).

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