Metastatic epithelioid trophoblastic tumor of the lung: A case report

Medicine (Baltimore). 2018 Apr;97(16):e0306. doi: 10.1097/MD.0000000000010306.

Abstract

Rationale: Epithelioid trophoblastic tumor (ETT) is a very rare form of gestational trophoblastic disease (GTD) which arises from neoplastic proliferation of intermediate trophoblasts. Metastatic ETT of the lung is extremely rare in postmenopausal women.

Patient concerns: Here we describe a 50-year-old woman with a metastatic ETT of the lung showing increasing tracer uptake at PET/CT.

Diagnosis: Hematoxylin-eosin staining showed a tumor composed of nests of epithelioid cells with necrotic debris and peritumoral hyaline-like material. Immunohistochemical staining of the tumor cells was positive for human chorionic gonadotropin (HCG) and cytokeratin 18.

Interventions: The patient underwent thoracoscopic lower left lobectomy combined with mediastinal lymphadenectomy. At surgery, a solid mass (size 3.0 × 3.0 cm) was found in the left lower lung.

Outcomes: The patient was discharged on the tenth day postsurgery, following an uneventful recovery. Three months postsurgery, the patient was asymptomatic and is currently being managed with close follow-up.

Lessons: Metastatic ETT of lung is a very rare disease. Complete surgical resection and chemotherapy may be the critical therapeutic option.

Publication types

  • Case Reports

MeSH terms

  • Chorionic Gonadotropin / analysis
  • Epithelioid Cells / pathology
  • Female
  • Humans
  • Immunohistochemistry
  • Keratin-18 / analysis
  • Lung Neoplasms* / metabolism
  • Lung Neoplasms* / pathology
  • Lung Neoplasms* / secondary
  • Lung Neoplasms* / surgery
  • Middle Aged
  • Pneumonectomy / methods*
  • Positron Emission Tomography Computed Tomography / methods
  • Thoracoscopy / methods*
  • Treatment Outcome
  • Trophoblastic Neoplasms / metabolism
  • Trophoblastic Neoplasms / pathology*

Substances

  • Chorionic Gonadotropin
  • Keratin-18