Abstract:
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 collaboration
between clinicians and pathologists can help make the diagnosis.
