Extrauterine epithelioid trophoblastic tumors presenting as lung mass: A case report and literature review

Medicine (Baltimore). 2019 Feb;98(5):e14010. doi: 10.1097/MD.0000000000014010.

Abstract

Rationale: Extrauterine epithelioid trophoblastic tumors (ETT) is a rare variant of gestational trophoblastic neoplasms. Here we aim to learn more clinical and pathological characteristics of ETT patient with an isolated pulmonary mass without uterine lesions, through a rare case of extra-uterine ETT and 7 cases published in English periodicals literature.

Patient concerns: A 31-year-old Chinese woman, presented with low-level elevation of serum human chorionic gonadotropin (HCG) for more than 2 years without abnormal symptoms. Dilation and curettage (D&C) was performed and histopathology revealed a secretory phase of endometrium. Chest computed tomography (CT) scan showed a 0.8 cm nodular lesion in the upper left lobe. Then a thoracotomy with left upper lobe segmentectomy was performed.

Diagnosis: After pathological and immunohistochemistry diagnosis, the case was confirmed as ETT (III).

Interventions: According to FIGO guideline, the patient took 3 cycles of multivalent chemotherapy consisting of cisplatin and etoposide, alternating with etoposid, methotrexate dactinomycin (EP-EMA).

Outcomes: The patient had no obvious signs of recurrence after 13 months of follow-up.

Lessons: When a fertile age woman persistently shows abnormal low-level escalation of HCG, ETT should be taken into consideration, especially lung X-ray or CT showing lesions without apparent abnormality of the uterus.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols
  • Chorionic Gonadotropin / blood
  • Diagnosis, Differential
  • Epithelioid Cells / pathology
  • Female
  • Gestational Trophoblastic Disease / diagnosis*
  • Gestational Trophoblastic Disease / drug therapy
  • Gestational Trophoblastic Disease / pathology*
  • Humans
  • Lung Diseases / diagnosis
  • Pregnancy

Substances

  • Chorionic Gonadotropin