Epithelioid trophoblastic tumor on posterior wall of uterus: a case Report

Abstract

Objective: Epithelioid trophoblastic tumour (ETT) is an unusual type of trophoblastic tumour, which can cause difficulties in diagnosis and in treatment. Case: A 40 year-old asymptomatic, pre-menopausal woman was admitted to hospital under suspicion for peritoneal cyste or endometriosis extragenitalis. Two month before a cystic tumor on posterior wall of uterus was detected by ultrasound examination. Her medical history showed epilepsy and lack of cholinesterase. Diagnostic laparoscopy and sample taking revealed poorly differentiated carcinoma, immunhistochemical similar to urothelial carcinoma. Further microscopical investigation and immunohistochemical studies disclose epithelioid trophoblastic tumour (ETT). Computed tomography did not show distant metastases or enlarged lymph nodes. The patient underwent abdominal hysterectomy and bilateral salpingectomy. Histopathological examination confirmed an epithelioid trophoblastic tumour (ETT). Serum β-hCG decreased from initially 11 IU/l to 1,4 IU/l within 14 days. An expectative policy was followed. Conclusion: In summary, we report an ETT with atypical presentation. Initial histological examination suggested that it was a urothelial carcinoma, but the diagnosis of ETT was later confirmed. Surgery should be the treatment of choice for ETT as it is not responsive to chemotherapeutic agents.