Human Chorionic Gonadotrophin Producing Epithelioid Sarcoma Metastatic to the Placenta

Abstract

Pregnancy complicated by sarcoma is a rare event, and metastasis to the placenta is exceptionally rare. Of reported malignancies involving the products of conception, only 8% are sarcomas. We report the first case of placental metastasis of an epithelioid sarcoma, an uncommon malignancy which most frequently affects young adults. In addition to the typical histological features and immunophenotypic profile expected of epithelioid sarcoma, this tumor also expressed human chorionic gonadotrophin (HCG). Although uncharacteristic, the production of HCG has been previously reported in other nontrophoblastic tumors. It may have contributed to the pathogenesis of the tumor metastatic to the placenta in this case.

Inflammatory Myofibroblastic Tumor of the Placenta

“…Metastatic involvement of the placenta by epithelioid sarcoma (ES) was described in a patient whose extremity lesion was present over a prolonged period, and who subsequently developed recurrence during pregnancy (34). Grossly, a mass was noted in the placenta, but on microscopic examination, large polygonal cells with pleomorphic nuclei were noted in the intervillous spaces.…”

Don’t cancel the surgery just yet! A case report of positive preoperative pregnancy test due to a soft tissue sarcoma production of ectopic beta human chorionic gonadotropin

“…In this report, the patient was a 57-year-old male with a 30-cm retroperitoneal mass which tested positive for the hormone after resection. A case report by Steffensen et al 12 in 2008 documented an epithelioid sarcoma which was metastatic to the placenta during pregnancy. They noted that only 8% of malignancies which metastasize to products of conception prove to be sarcoma.…”