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Case Reports
. 2018 Apr;97(16):e0306.
doi: 10.1097/MD.0000000000010306.

Metastatic epithelioid trophoblastic tumor of the lung: A case report

Wangjun Lei  1 , Fangbiao Zhang, Chunhui Zheng, Chun Zhao, Shaosong Tu, Yingwei Bao
Affiliations
Case Reports

Metastatic epithelioid trophoblastic tumor of the lung: A case report

Wangjun Lei et al. Medicine (Baltimore). 2018 Apr.

Abstract

Rationale: Epithelioid trophoblastic tumor (ETT) is a very rare form of gestational trophoblastic disease (GTD) which arises from neoplastic proliferation of intermediate trophoblasts. Metastatic ETT of the lung is extremely rare in postmenopausal women.

Patient concerns: Here we describe a 50-year-old woman with a metastatic ETT of the lung showing increasing tracer uptake at PET/CT.

Diagnosis: Hematoxylin-eosin staining showed a tumor composed of nests of epithelioid cells with necrotic debris and peritumoral hyaline-like material. Immunohistochemical staining of the tumor cells was positive for human chorionic gonadotropin (HCG) and cytokeratin 18.

Interventions: The patient underwent thoracoscopic lower left lobectomy combined with mediastinal lymphadenectomy. At surgery, a solid mass (size 3.0 × 3.0 cm) was found in the left lower lung.

Outcomes: The patient was discharged on the tenth day postsurgery, following an uneventful recovery. Three months postsurgery, the patient was asymptomatic and is currently being managed with close follow-up.

Lessons: Metastatic ETT of lung is a very rare disease. Complete surgical resection and chemotherapy may be the critical therapeutic option.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
A computed tomography (CT) scan of the chest revealed a 3.0 × 3.0 cm left lung mass. Maximum intensity projection PET (D) and axial (B) CT, corresponding PET (A), and fused (C) images showed FDG uptake of the lesion (arrow) with SUVmax of 6.5.
Figure 2
Figure 2
Low-power photomicrograph (A, hematoxylin–eosin, original magnification ×40) revealed the tumor cells in nests and the area of geographic hyalinizing necrosis.
Figure 3
Figure 3
High-power photomicrograph (B, hematoxylin–eosin, original magnification ×200) showed epithelioid cells with necrotic debris and peritumoral hyaline-like material.
Figure 4
Figure 4
Immunohistochemical staining of the tumor cells was strongly positive for human chorionic gonadotropin (HCG) (C, original magnification ×100).
See this image and copyright information in PMC

References

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