Open AccessDiagnosing and treating rare lesions in a low resource setting: lessons from a hybrid epithelioid trophoblastic tumor and choriocarcinoma
Author(s) -
Patrick Kafui Akakpo,
Kofi UlzenAppiah,
Evans Kofi Agbeno,
Leonard Derkyi-Kwarteng
Publication year - 2018
Publication title -
ghana medical journal
Language(s) - English
Resource type - Journals
eISSN - 2616-163X
pISSN - 0016-9560
DOI - 10.4314/gmj.v51i4.9
Subject(s) - medicine , choriocarcinoma , vaginal bleeding , hysterectomy , miscarriage , pathology , radiology , gynecology , pregnancy , biology , genetics
Objective: To raise awareness of the existence of a rare type of malignant trophoblastic tumor and discuss the diagnostic challenges and management of this lesion in a low resource setting.Case report and intervention: A 35 -year -old G6P3 woman was referred to our facility on account of persistent vaginal bleeding due to a suspected incomplete miscarriage with a cervical mass. Her serum β-HCG was elevated (36,900 mIU/ml) and examination showed a bleeding cervical mass. An initial histopathological diagnosis of moderately differentiated squamous cell carcinoma was reviewed to epithelioid trophoblastic tumor resulting in an extra-fascial hysterectomy. A final histopathological diagnosis of hybrid Epithelioid Trophoblastic Tumor and Choriocarcinoma (ETT/CC) was made after external review and immunohistochemistry. She received subsequent chemotherapy.Conclusion: Epithelioid trophoblastic tumor and its hybrids are difficult to diagnose. They may be diagnosed as moderately differentiated squamous cell carcinoma especially in low resource settings where cervical squamous cell carcinoma is relatively more common. A high index of suspicion, a serum β HCG test and close collaborationbetween clinicians and pathologists can help make the diagnosis.Funding: NoneKeywords: Epithelioid trophoblastic tumour, choriocarcinoma, diagnostic challenges, low resource setting