Noh HT, Lee KH, Lee MA, Ko YB, Hwang SH, Son SK. Epithelioid trophoblastic tumor of paracervix and parametrium. Int J Gynecol Cancer 2008;18:843-846.Epithelioid trophoblastic tumor (ETT) is an unusual variant of gestational trophoblastic tumor that is closely related to choriocarcinoma and placental site trophoblastic tumor but shows different morphologic and immunohistochemical features. We report an ETT discovered in paracervix, parametrium, and periadnexal soft tissue of a 44-year-old woman. She underwent laparoscopic surgery and four courses of chemotherapy with a regimen of etoposide, methotrexate, and dactinomycin. ETT has a distinctive growth pattern and immunohistochemical profile. The difficulties and clues in distinguishing ETT from nontrophoblastic lesions are discussed.

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There are over 100 subtypes of human papillomavirus (HPV) and HPV infections are associated with benign and malignant lesions of cutaneous and mucosal epithelia [1]. Although several studies have compared the HPV status in cervical scrapes and biopsy specimens, it still remains uncertain as to how well each of these clinical samples represents the actual HPV status of the patient's cervix.To investigate whether the HPV status in scrape samples represents that in the overall cervix, the HPV status of a total of 190 scrapes and biopsy specimens from 95 women was assessed by using a highly sensitive HPV genotyping DNA microarray [2]. The concordance of HPV detection in both the cervical scrapes and biopsy specimens was shown to be no significant difference in grade of cervical neoplasia ( p = 0.54) and the frequency of complete concordant genotyping results was also not significantly different in each class of cervical neoplasia ( p = 0.229) ( Table 1).The spectrum of HPV infections between the scrapes and the biopsy specimens is summarized in Table 2. In the cervical scrapes, the majority of the samples (62.2%) were infected with single type of high-risk HPV, while 12 cases of 74 HPV-positive women (16.2%) showed mixed infections and 16 cases were infected with the multiple high-risk types (21.6%). The infection status of the 0020-7292/$ -see front matter D corresponding biopsy specimens showed similar patterns to the scrapes. In both types of samples, the infection rate of the single high-risk type was significantly higher than that of the multiple highrisk types ( p b 0.001), but there was no significant difference in infection rate between the single and multiple high-risk types. As shown in Table 2, the frequency of the multiple genotypes in the scrapes was slightly higher than that in the biopsies, even has no statistical significance. In addition, the spectrum of the HPV genotypes detected in the cervical scrapes was more varied than in the corresponding biopsy specimens (data not shown). This result is agreed to that a HPV genotyping with scrapes more accurately reflects the spectrum of HPV genotypes present in the cervix [3].In summary, this study showed that the scrapes reflect more accurate information about spectrum of HPV genotypes and represent the actual HPV status of the patient's cervix in clinical setting.

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