Isolated Epithelioid Trophoblastic Tumor Mimicking Non-small Cell Lung Cancer

Abrão, Fernando Conrado; Sabbion, Rodrigo Olivio; Canzian, Mauro; Fernandez, Ângelo; Fushida, Koji; Pêgo-Fernandes, Paulo Manuel; Jatene, Fábio Biscegli

doi:10.1097/jto.0b013e318215a214

Cited by 8 publications

(7 citation statements)

References 5 publications

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“…The interval between prior gestation or gestational trophoblastic tumor and ETT can range from 2 weeks to 30 years [8,9]. Extrauterine ETT in the absence of a uterine tumor has been documented in the lung, parametrial tissue, broad ligament, liver, spine, orbit and lymph nodes [8,9,10,11,12,13,14]. …”

Section: Discussionmentioning

confidence: 99%

Epithelioid Trophoblastic Tumor: Report of Two Cases in Postmenopausal Women with Literature Review and Emphasis on Cytological Findings

Almarzooqi

Al-Safi²,

Al-Jassar³

et al. 2014

Acta Cytologica

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Background: Epithelioid trophoblastic tumor (ETT) is a rare gestational trophoblastic neoplasm of intermediate trophoblasts. It was first described by Shih and Kurman [Am J Surg Pathol 1998;22:1393-1403] who outlined its clinicopathologic characteristics in 14 cases, establishing it as a distinct entity of gestational trophoblastic tumors. It represents 1.39% of all gestational trophoblastic diseases. Most cases are reported in reproductive-age women following a prior gestation with a time interval between 2 weeks and 30 years. ETT is extremely rare in postmenopausal women. It is commonly misdiagnosed as a squamous cell carcinoma (SCC), poorly differentiated carcinoma or another gestational trophoblastic tumor. Limited data is available regarding its cytological features on Pap smears. Cases: We report 2 cases of uterine ETT occurring in postmenopausal women. In both cases, an initial diagnosis of an SCC and a poorly differentiated carcinoma was rendered. We highlight the features of ETT helpful in differentiating it from other mimickers with emphasis on rarely reported cytological features of this neoplasm. Conclusion: ETT is a rare tumor with characteristic cytological features, but is commonly confused with SCC. A high index of suspicion is needed to make the correct diagnosis or to raise the consideration of ETT, especially in cases with an increased β-human chorionic gonadotropin.

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Section: Discussionmentioning

confidence: 99%

Epithelioid Trophoblastic Tumor: Report of Two Cases in Postmenopausal Women with Literature Review and Emphasis on Cytological Findings

Almarzooqi

Al-Safi²,

Al-Jassar³

et al. 2014

Acta Cytologica

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“…22,24 Preoperative biopsy was misdiagnosed as squamous cell carcinoma or adenosquamous cell carcinoma in 7 patients (7/78 [8.97%]). 9,10,22,31,34,43,44 The sites of these misdiagnosed tumors included the lower uterine segment/cervix (n = 6) and lung (n = 1). The typical immunostaining pattern consisted of diffuse positive staining with pan-cytokeratin, cytokeratin 18, epithelial membrane antigen, inhibin, and nuclear p63 as well as focal staining for A-hCG and human placental lactogen.…”

Section: Pathological Featuresmentioning

confidence: 99%

Epithelioid Trophoblastic Tumor: An Outcome-Based Literature Review of 78 Reported Cases

Zhang¹,

Lü

2013

Int J Gynecol Cancer

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This analysis confirms the hypothetical chemotherapy resistance and prognostic value of FIGO staging in ETT. These findings remain tentative given the small data set available for analysis and the reporting bias from these published cases; however, they may confer a risk-adapted therapy. Finally, both gynecologists and pathologists should be alert to the potential misdiagnosis of squamous cell carcinoma when ETT is present in the lower uterine segment/cervix.

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“…The "classic" trophoblast markers, including hPL, β-HCG, and Mel-CAM (CD146), which are diffusely expressed in normal implantation-site intermediate trophoblast and placental site trophoblastic tumor, are focally expressed in ETT. [1][2][3][4][5][6][7][8][9][10] The differential diagnosis of ETT includes other primary ovarian tumors mainly clear cell carcinoma with a predominant solid pattern. The cytological features may overlap between both diagnoses because of the round to epithelioid cell appearance, the pale to eosinophilic cytoplasm and the large moderately pleomorphic nuclei.…”

Section: Discussionmentioning

confidence: 99%

“…Deposition of eosinophilic hyaline-like material is characteristically present in the center of tumor nests or between tumor cells. 1-11 The cells are relatively uniform with a moderate amount of finely granular, eosinophilic to clear cytoplasm, distinct cellular membranes and round nuclei with distinct nucleoli. Nuclear atypia is generally mild, but rare cases showed diffuse moderate to severe nuclear atypia with larger cells showing multinucleation or degenerated angulated and smudged nuclei similar to our case.…”

Section: Discussionmentioning

confidence: 99%

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Extrauterine Epithelioid Trophoblastic Tumor Arising in the Ovary With Multiple Metastases

et al. 2015

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Epithelioid trophoblastic tumor is a neoplasm of the chorionic-type intermediate trophoblasts. It is considered a rare gestational trophoblastic disease and is frequently misdiagnosed as carcinoma. Extrauterine epithelioid trophoblastic tumor has been reported in multiple anatomical sites. We report a case of a 50-year-old woman who presented with abdominal pain and distension. Her initial β-human chorionic gonatotropin level was 806.7 IU/L. Imaging showed a large complex ovarian mass with peritoneal and subcapsular hepatic deposits as well as pulmonary nodules. Morphological features of the tumor and its immunohistochemical reactivity to CK8/18, CK7, p63, and CD10 were consistent with the diagnosis of an extrauterine epithelioid trophoblastic tumor arising from the ovary. The differential diagnoses, including other ovarian tumors, were ruled out on the basis of morphology and negative immunostaining to a relatively extended panel of antibodies. A prolonged follow up of these cases and the recognition of such rare tumors in unusual sites are crucial to the diagnosing pathologist and treating physician.

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Isolated Epithelioid Trophoblastic Tumor Mimicking Non-small Cell Lung Cancer

Cited by 8 publications

References 5 publications

Epithelioid Trophoblastic Tumor: Report of Two Cases in Postmenopausal Women with Literature Review and Emphasis on Cytological Findings

Epithelioid Trophoblastic Tumor: Report of Two Cases in Postmenopausal Women with Literature Review and Emphasis on Cytological Findings

Epithelioid Trophoblastic Tumor: An Outcome-Based Literature Review of 78 Reported Cases

Extrauterine Epithelioid Trophoblastic Tumor Arising in the Ovary With Multiple Metastases

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