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A rare case of epithelioid trophoblastic tumor: an ultrasound dilemma

April Anne P. Bolo-Paiso, MD, FPOGS and Melissa D.L. Amosco, MD, PhD, FPOGS, FPSUOG
Department of Obstetrics and Gynecology, Philippine General Hospital, University of the Philippines-Manila

Gestational trophoblastic neoplasia (GTN) represents the malignant end of the gestational trophoblastic disease spectrum and includes the more common types, invasive mole (IM) and choriocarcinoma (CC) and the rare types, placental site trophoblastic tumor (PSTT) and epithelioid trophoblastic tumor (ETT).

This is a case of a 42-year-old, G2P2 (2002) patient who complained of left lower quadrant pain and a 1 year history of amenorrhea. Urine pregnancy test done just prior to the surgery revealed positive result. Pre-operative diagnosis was abdominopelvic mass mass probably Sarcoma, ovarian new growth probably benign, right. Patient underwent exploratory laparotomy, adhesiolysis, bilateral internal iliac artery ligation, total hysterectomy with bilateral salpingo-oophorectomy, targeted biopsy, appendectomy, JP drain insertion under epidural anesthesia. Final histopathologic and immunohistochemical diagnosis is Epithelioid Trophoblastic Tumor.

Differential diagnoses, diagnostics, and therapeutic options are presented, with focus on the description of sonographic features.