Medicine:Epithelioid trophoblastic tumour
From HandWiki
| Epithelioid trophoblastic tumour | |
|---|---|
| Specialty | Oncology |
Epithelioid trophoblastic tumor (ETT) is a gestational trophoblastic disease with about 110 case reports in the literature. It is a trophoblastic tumor of neoplastic chorionic type associated with the intermediate trophoblast.
Signs and symptoms
- Vaginal bleeding: The most common presenting symptom is vaginal bleeding, which is associated with mild elevation of serum β hCG (< 2,500 IU/L)
- Amenorrhea.
Morphology
Gross appearance
- There is deep infiltration of the surrounding structures by cystic hemorrhagic masses or discrete nodules.
- Necrosis is present with white to tan-brown cut surface with hemorrhage.
- Ulceration (common finding)
- Fistula (common finding)
Microscopic appearance
- Nodular, well circumscribed, focal infiltrative at the periphery.
- Uniform, mononucleate tumor cells are arranged in nests and cords.
- Tumor nests are associated with eosinophilic, fibrillar, hyaline-like material.
- Extensive necrosis with irregular contours.
- Calcification (common finding)
- Metaplastic endocervical or endometrial surface epithelium into squamous-like epithelium.
Locations
Common locations are:
- Uterus
- Lower uterine segment (40%)
- Cervix (31% of cases)
- Lungs (19% of cases)
They may rarely develop in
- Vagina
- Broad ligament
- Fallopian tubes
- Other pelvic organs
Diagnosis
Treatment
Epithelioid trophoblastic tumors (ETTs) are resistant to chemotherapy, but an immunotherapy drug called dostarlimab treats gestational trophoblastic neoplasia. ETT is a form of GTN. Stage I disease is treated with hysterectomy, while metastatic disease is treated with surgery and chemotherapy. [2]
Prognosis
Metastasis occur in 25% of cases and 10% die of the disease. Mitotic count of > 6/10HPF is an unfavorable prognostic factor. [2]
References
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