Placental site and epithelioid trophoblastic tumours: Diagnostic pitfalls

Moutte, Amandine; Doret, Muriel; Hajri, Touria; Peyron, N.; Chateau, Florence; Massardier, Jérôme; Duvillard, P.; Raudrant, D.; Golfier, François

doi:10.1016/j.ygyno.2012.11.010

Cited by 36 publications

(30 citation statements)

References 22 publications

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“…We searched clinical records for all patients with ETT and PSTT from Medical Record Review System during May 2004 to December 2013 in the Women's Hospital, School of Medicine, Zhejiang University. To avoid pitfalls in the histological diagnosis of ETT and PSTT [5] , we deliberately reconfirmed all the postoperative specimens of ETT and PSTT by two pathologists (B. Lu and Y. Liang) according to the WHO tumor classification guidance (2003) [12] , and further verified difficult cases by a panel of antibodies including hPL, CD146, p63 etc [13] , [14] . Except the cases lacking pre-surgical ultrasound documents, we finally recruited 12 ETT and 21 PSTT patients with reconfirmed pathological diagnosis.…”

Section: Methodsmentioning

confidence: 99%

“…Surgical intervention is recommended for ETT patients as the primary choice of treatment [4] . In clinical practice, however, due to its low incidence and limited knowledge, ETT has a high chance of being misdiagnosed and subsequently mismanaged [2] , [5] , [6] , which may lead to progressive tumor development, metastasis, and poor prognosis [4] , [7] . Therefore, an accurate diagnosis is essential to minimize the risk of mistreatment.…”

Section: Introductionmentioning

confidence: 99%

“…However, little is known about the sonographic features of ETT due to its exceedingly low incidence [8] . To date, the published studies mainly focused on clinicopathological features of ETT [1] , [5] , [7] , [10] , and provided little insight into sonography [11] . The aim of this study was to identify discriminative sonographic features for the pre-operative diagnosis of ETT.…”

Section: Introductionmentioning

confidence: 99%

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A Well-Circumscribed Border with Peripheral Doppler Signal in Sonographic Image Distinguishes Epithelioid Trophoblastic Tumor from Other Gestational Trophoblastic Neoplasms

et al. 2014

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As epithelioid trophoblastic tumor (ETT) shares similar clinical features with other gestational trophoblastic neoplasms (GTNs), it is likely to be clinically misdiagnosed and subsequently treated in an improper way. This study aimed to identify the sonographic features of ETT that are distinct from other GTNs, including placental site trophoblastic tumor (PSTT) and invasive mole/choriocarcinoma (IM/CC). Here, we retrospectively analyzed ultrasound images of 12 patients with ETT in comparison with those of 21 patients with PSTT and 24 patients with IM/CC. The results showed that maximal diameter and hemodynamic parameters were not significantly different among ETT, PSTT and IM/CC (P>0.05). However, a well-circumscribed border with hypoechogenic halo was identified in the gray-scale sonogram in all 12 cases of ETT, while only in 1 out of 21 cases of PSTT and 1 out of 16 cases of IM/CC (P<0.001 for ETT vs. PSTT or IM/CC). Moreover, a peripheral pattern of Doppler signals was observed in 11 out of 12 ETT lesions, showing relatively more Doppler signal spots around the tumor border than within the boundary, while a non-peripheral pattern of Doppler signals in all 21 PSTT cases and 14 out of 16 IM/CC cases: with minimal, moderate or remarkable signal spots within the tumor, but not along the tumor (P<0.001 for ETT vs. PSTT or IM/CC). These distinct sonographic features of ETT correlated with histopathologic observations, such as expansive growth pattern and vascular morphology. Thus, we draw the conclusions that the well-circumscribed border with peripheral Doppler signal may serve as a reliable sonographic feature to discriminate ETT from other types of GTNs. With further validation in a larger patient set in our ongoing multi-center study, this finding will be potentially developed into a non-invasive pre-operative GTN subtyping method for ETT.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Well-Circumscribed Border with Peripheral Doppler Signal in Sonographic Image Distinguishes Epithelioid Trophoblastic Tumor from Other Gestational Trophoblastic Neoplasms

et al. 2014

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“…Hence, it is imperative that a distinction is made between the two entities, each of which has a different histological appearance. 7 An ETT has a nodular growth pattern with expansile borders, in contrast to the dissecting pattern of myometrial infiltration seen with a PSTT.…”

Section: Discussionmentioning

confidence: 99%

Epithelioid trophoblastic tumour: a report of two cases

Elhassan

Wijk

2015

Southern African Journal of Gynaecological Oncology

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“…In one study [4], PSTT was found to have malignant and metastatic potential. Owing to the slow biological behavior of PSTT, affected patients are often resistant to chemotherapy [7]. Thus, the tumor can recur and metastasize, even for patients with stage I disease.…”

Section: Introductionmentioning

confidence: 99%