Metastatic Epithelioid trophoblastic tumor in lymph nodes: Case report

Abstract

Introduction: Epithelioid trophoblastic tumor (ETT) is a kind of trophoblastic tumors that is arising from placenta. Since it is extremely rare, estimation of its prevalence is difficult. Involvement of lower uterine segment and cervix in this tumor is unique when compared with other types of trophoblastic tumors. ETT is similar to placental site trophoblastic tumors (PSTTs), in terms of growing slowly, producing low levels of HCG and resistance to chemotherapy. Optimal surgery is always the first and the best approach. In this article, an extremely rare case of metastatic ETTs in the lymph nodes is reported. Case presentation: A 49 year old women G3L3 presented with menorrhagia in recent 4 months and being severe, she underwent emergency curettage. Pathology report was pregnancy products. Because of exaggerated vaginal bleeding and plateaued hcg levels (40MIU/MIL), hysterectomy was performed. Pathology report was ETT. Conclusion: Abnormal vaginal bleeding can be the signs of normal or abnormal pregnancy and it is necessary to check hcg level. ETT is usually associated with misdiagnosis or delay in diagnosis which leads to mismanagement of the disease and reducing its survival. Therefore, in diagnosis of molar diseases, regarding to resistance to chemotherapy, the best surgical approach should be performed for the patient.

Keywords

• choriocarcinoma
• epithelioid trophoblastic tumor
• placental site tumors