Uterine Epithelioid Trophoblastic Tumor

Abstract

A woman in her early 60s presented with postmenopausal bleeding. Pelvic ultrasound examination identified a large uterine mass. The patient underwent total hysterectomy to remove this uterine mass. Which of the following is a malignant trophoblastic neoplasm that can develop many years after pregnancy?a.Placental site noduleb.Exaggerated implantation sitec.Epithelioid trophoblastic tumord.Endometrial stromal sarcoma Answer: c. Epithelioid trophoblastic tumor Epithelioid trophoblastic tumor is a rare malignant neoplasm of chorionic-type intermediate trophoblast.1WHO Classification of Tumors5th ed. Female Genital Tumors. Vol 4. International Agency for Research on Cancer, Lyon2020Google Scholar Epithelioid trophoblastic tumor is generally not associated with specific symptoms, but vaginal bleeding or menometrorrhagia is often noted, as is low elevation of serum β-human chorionic gonadotropin.1WHO Classification of Tumors5th ed. Female Genital Tumors. Vol 4. International Agency for Research on Cancer, Lyon2020Google Scholar Epithelioid trophoblastic tumor can develop within a year of and up to 2 decades after an antecedent gestation and thus can be seen in postmenopausal patients. Epithelioid trophoblastic tumor forms a solid to cystic mass most commonly in the cervix or lower uterine segment with varying amounts of necrosis and hemorrhage. On microscopic examination, the tumor shows infiltrative mononuclear epithelioid cytologically atypical intermediate trophoblastic cells, often forming nests with hyalinization or necrosis centrally.2Fadare O. Parkash V. Carcangiu M.L. Hui P. Epithelioid trophoblastic tumor: clinicopathological features with an emphasis on uterine cervical involvement.Mod Pathol. 2006; 19: 75-82Crossref PubMed Scopus (76) Google Scholar