scholarly journals Epithelioid Trophoblastic Tumor: A Case Report and Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Eirwen M. Scott ◽  
Ashlee L. Smith ◽  
Mohamed Mokhtar Desouki ◽  
Alexander B. Olawaiye
Keyword(s):  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Diagnostic Challenge ◽  
Postoperative Evaluation ◽  
Trophoblastic Tumor ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Epithelioid Trophoblastic Tumor ◽  
Abnormal Vaginal Bleeding ◽  
Laparoscopic Assisted ◽  
Disease Free

Epithelioid trophoblastic tumor (ETT) is a rare gestational trophoblastic tumor. Cases of ETT present as abnormal vaginal bleeding in women of reproductive age, with low human chorionic gonadotropin (hCG) levels. ETT can be a sequela of any gestational event and can present in both intrauterine and extrauterine sites. Metastasis and death have been reported. We present a case of a 44-year-old female incidentally diagnosed with ETT following laparoscopic-assisted vaginal hysterectomy. Postoperative evaluation for metastatic disease was negative. The patient has been closely followed and remains disease free 8 months postoperatively. ETT presents a diagnostic challenge due to its rarity and histologic resemblance to other pathologies. ETT is relatively chemoresistant and managed surgically. Misdiagnosis delays effective treatment and affects survival.

scholarly journals Uterine Epithelioid Trophoblastic Tumor in a 44-Year-Old Woman: A Diagnostic Dilemma

2021 ◽  
Vol 11 (3) ◽  
pp. 631-639
Author(s):  
Maria-Gabriela Aniţei ◽  
Diana-Elena Lazăr ◽  
Raluca Alina Pleşca ◽  
Cristina Terinte ◽  
Radu Iulian ◽  
...  
Keyword(s):  
Reproductive Age ◽  
Diagnostic Challenge ◽  
Diagnostic Dilemma ◽  
Natural Childbirth ◽  
Trophoblastic Tumor ◽  
Epithelioid Trophoblastic Tumor ◽  
Uterine Curettage ◽  
Normal Human ◽  
Poorly Differentiated ◽  
Β Hcg

Background: Epithelioid trophoblastic tumor (ETT) is a rare and newly defined disease, which most commonly occurs in women of reproductive age and can be a sequela of any gestational event. ETT can be present in both intrauterine and extrauterine sites. Case report: A woman of reproductive age, without specific comorbidities and with a single pregnancy and natural childbirth eight years ago, was diagnosed initially with poorly differentiated pleomorphic leiomyosarcoma on the hemostatic uterine curettage. Conclusion: Our case highlights that ETT presents a diagnostic challenge due to its rarity and histologic resemblance to other pathologies. Misdiagnosis delays effective treatment and affects survival. To date, only 8 cases of ETT of the uterus without previous gestational event and normal human chorionic gonadotropin (β-HCG) levels in a 60-year literature survey have been reported.

Epithelioid Trophoblastic Tumor: Review of a Rare Neoplasm of the Chorionic-Type Intermediate Trophoblast

2006 ◽  
Vol 130 (12) ◽  
pp. 1875-1877
Author(s):  
Kimberly H. Allison ◽  
Jason E. Love ◽  
Rochelle L. Garcia
Keyword(s):  
Gestational Trophoblastic Disease ◽  
Reproductive Age ◽  
Placental Lactogen ◽  
Variable Expression ◽  
Trophoblastic Tumor ◽  
Trophoblastic Cells ◽  
Epithelioid Trophoblastic Tumor ◽  
Positive Immunostaining ◽  
Nodular Growth ◽  
Type Intermediate

Abstract We present a brief review of epithelioid trophoblastic tumor, a rare trophoblastic neoplasm derived from chorionic-type intermediate trophoblastic cells that typically presents in reproductive-age women between 1 and 18 years following a previous gestation. Histologic features include a nodular growth pattern of monomorphic, epithelioid cells within a hyaline matrix. Areas of necrosis and mitotic activity (0–9 mitoses per 10 high-power fields) are additional features of this neoplasm. Positive immunostaining for p63 and cytokeratin, frequent location in the lower uterine segment and endocervix, as well as the epithelioid appearance can lead to confusion with squamous cell carcinoma. Inhibin-α is typically expressed, as well as focal, more variable expression of other trophoblastic markers including β-human chorionic gonadotropin, human placental lactogen, placental alkaline phosphate, and Mel-CAM (CD148). The clinical behavior of this rare form of gestational trophoblastic disease is difficult to predict. Although most cases follow a benign course following resection, there is a potential for metastatic disease.

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

2013 ◽  
Vol 23 (7) ◽  
pp. 1334-1338 ◽  
Author(s):  
Xiaofei Zhang ◽  
Weiguo Lü ◽  
Bingjian Lü
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Figo Stage ◽  
Lower Uterine Segment ◽  
Reproductive Age ◽  
Small Data ◽  
Data Set ◽  
Trophoblastic Tumor ◽  
Epithelioid Trophoblastic Tumor

ObjectivesEpithelioid trophoblastic tumor (ETT) is very rare; and therefore, a substantially increased data set is unlikely to be obtained in the near future. This analysis aimed to assess the effects of current management on clinical outcomes and to identify potential prognostic indicators in ETT.MethodsWe applied a literature search using PubMed to analyze the clinical data of 78 published cases of ETT.ResultsWomen with ETT present at reproductive age (mean ± SD, 37.1 ± 8.7 years) and have a slightly to moderately elevated serum β-human chorionic gonadotropin (median, 665 IU/L). Epithelioid trophoblastic tumor is frequently present in the lower uterine segment/cervix (26/58 cases) and can be misdiagnosed as squamous cell carcinoma (6/26). Lung is the most common extrauterine site of ETT (5/11 with uterine ETT and 10/20 without uterine ETT). Kaplan-Meier analysis indicates that chemotherapy (surgery with postoperative chemotherapy vs surgery alone) is associated with increased ETT relapse (P= 0.005), even after stratification by International Federation of Gynecology and Obstetrics (FIGO) stage (P= 0.008); but FIGO stage remains the only significant prognostic indicator for ETT (P= 0.015).ConclusionsThis 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.

scholarly journals Abnormal vaginal bleeding in women of reproductive age: a descriptive study of initial management in general practice

2008 ◽  
Vol 8 (1) ◽  
Author(s):  
Corlien JH de Vries ◽  
Margreet Wieringa-de Waard ◽  
Cléo-Lotte AG Vervoort ◽  
Willem M Ankum ◽  
Patrick JE Bindels
Keyword(s):  
General Practice ◽  
Vaginal Bleeding ◽  
Descriptive Study ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Initial Management ◽  
Abnormal Vaginal Bleeding

scholarly journals Cystic Endometriosis in a Huge Degenerated Subserous Leiomyoma Mimicking Bilateral Multicystic Endometriomas in an Infertile Woman with Diminished Ovarian Reserve: A Rare Endometriotic Implantation

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Safak Hatirnaz ◽  
Sabri Colak ◽  
Abdulkadir Reis
Keyword(s):  
Uterine Leiomyoma ◽  
Cystic Mass ◽  
Reproductive Age ◽  
Infertile Woman ◽  
Cystic Degeneration ◽  
Women Of Reproductive Age ◽  
Diagnostic Challenge ◽  
Peritoneal Disease ◽  
Pubmed Search ◽  
History Of

Uterine leiomyomas are the most common pelvic tumor in women. Leiomyoma can show atypical locations and degenerations and may not be easily differentiated from adnexal masses. Uterine leiomyoma can undergo cystic degeneration and is said to be found in 4% of all types of degenerations. The commonest type of degeneration is hyaline seen in 60% of patients. Usually uterine leiomyoma does not present as clinical and radiological diagnostic challenge. However, when leiomyoma undergoes massive cystic degeneration they may become clinical and radiological diagnostic dilemmas. The MRI showed a huge cystic mass protruding up to the pelvis not differentiated from bilateral endometriomas and accompanying subserous myomas. Surgery revealed that the mass is not bilateral endometriomas but a huge pedunculated leiomyoma with cystic degeneration and cystic endometriosis. Endometriosis is a troubling gynecologic condition occurring in 10% to 15% of women of reproductive age and is associated with fertility problems. As a peritoneal disease, the locations of endometriotic lesions are predominantly the ovaries (96.4%), followed by the soft tissue (2.8%), gastrointestinal tract (0.3%), and urinary tract (0.2%) and other rare locations. The presented case is multiple sized cystic endometriosis (endometriomas) located in a huge pedunculated subserous leiomyoma in an infertile woman having a history of laparoscopic bilateral endometrioma surgery.Conclusion. To our knowledge, this is the first reported case for endometriotic cysts (endometriomas) located in a huge cystic degenerated leiomyoma. PubMed search revealed no report concerning endometriotic implantation in the leiomyomas.

scholarly journals Acute pancreatitis masquerading as an ovarian torsion: a rare case report

2021 ◽  
Vol 11 (1) ◽  
pp. 284
Author(s):  
Ankita Bansal Goyal ◽  
Lata Goyal ◽  
Nilesh Goyal ◽  
Saket Jain
Keyword(s):  
Acute Pancreatitis ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Acute Abdominal Pain ◽  
Ovarian Torsion ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Diagnostic Challenge ◽  
Post Operative Period ◽  
Rare Case Report

Ovarian torsion is a common diagnostic challenge constituting 2.7% to 7.4% of all gynaecological emergencies. It commonly occurs in women of reproductive age however pre-pubertal girls and postmenopausal women can also be affected. Ovarian torsion accounts for approximately 3% of all cases of children with acute abdominal pain and requires immediate surgical intervention. Other common acute adnexal pathologies include simple ovarian cysts (OCs) with or without rupture. Owing to the nonspecific clinical presentation and poor specificity of radiologic tests, the diagnosis of OT in girls remains challenging. Here we are reporting a case of acute abdomen with large cyst on ultrasound clinically presented as torsion later on in the post-operative period diagnosed with acute pancreatitis.

Evaluation of concomitant gynecological pathology in group of patients of reproductive age with tumors and tumor formations

2020 ◽  
pp. 10-14
Author(s):  
N. V. Spiridonova ◽  
A. A. Demura ◽  
V. Yu. Schukin
Keyword(s):  
Diagnostic Errors ◽  
Ovarian Tumors ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Predisposing Factor ◽  
Ovarian Tumours ◽  
Preoperative Diagnostic ◽  
Neoplastic Process ◽  
History Of ◽  
The Moment

According to modern literature, the frequency of preoperative diagnostic errors for tumour-like formations is 30.9–45.6%, for malignant ovarian tumors is 25.0–51.0%. The complexity of this situation is asymptomatic tumor in the ovaries and failure to identify a neoplastic process, which is especially important for young women, as well as ease the transition of tumors from one category to another (evolution of the tumor) and the source of the aggressive behavior of the tumor. The purpose of our study was to evaluate the history of concomitant gynecological pathology in a group of patients of reproductive age with ovarian tumors and tumoroid formations, as a predisposing factor for the development of neoplastic process in the ovaries. In our work, we collected and processed complaints and data of obstetric and gynecological anamnesis of 168 patients of reproductive age (18–40 years), operated on the basis of the Department of oncogynecology for tumors and ovarian tumours in the Samara Regional Clinical Oncology Dispensary from 2012 to 2015. We can conclude that since the prognosis of neoplastic process in the ovaries is generally good with timely detection and this disease occurs mainly in women of reproductive age, doctors need to know that when assessing the parity and the presence of gynecological pathology at the moment or in anamnesis, it is not possible to identify alarming risk factors for the development of cancer in the ovaries.

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