MR Imaging of Uterine Epithelioid Trophoblastic Tumor

Epithelioid trophoblastic tumor (ETT) is a rare gestational trophoblastic neoplasm of chorionic-type intermediate trophoblasts, and it is most frequently located in the lower uterine segment and endocervix. Due to the epithelial-growth pattern with geographic necrosis exhibited by the neoplastic cel...

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Published inMagnetic resonance in medical sciences Vol. 15; no. 4; p. 411
Main Authors KAGEYAMA, Sakiko, KANOTO, Masafumi, SUGAI, Yukio, SUTO, Takeshi, NAGASE, Satoru, OSAKABE, Mitsumasa, HOSOYA, Takaaki
Format Journal Article
LanguageEnglish
Published Tokyo Japan Science and Technology Agency 01.10.2016
Subjects
Calcification
Carcinoma
Cervix
Computed tomography
Diagnosis
Enlargement
Epithelial cells
Hemorrhage
Magnetic resonance imaging
Medical imaging
Necrosis
Neoplasia
Pain
Segments
Squamous cell carcinoma
Trophoblastic disease
Trophoblasts
Tumors
Uterine cancer
Uterus
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Summary:Epithelioid trophoblastic tumor (ETT) is a rare gestational trophoblastic neoplasm of chorionic-type intermediate trophoblasts, and it is most frequently located in the lower uterine segment and endocervix. Due to the epithelial-growth pattern with geographic necrosis exhibited by the neoplastic cells, ETT is commonly confused, both clinically and pathologically, with squamous cell carcinoma. Although there have been no previous reports of ETT focusing on computed tomography (CT) or magnetic resonance imaging (MRI) findings, we report a case of uterine ETT with special attention to the MRI findings referring to the pathological findings and MR images of previous reports. A 42-year-old Japanese woman (gravid 1, para 1) presented with uterus enlargement during screening, and complained of recent-onset lower abdominal pain. The MRI showed a solid tumor throughout the entire myometrium of the lower uterine segment, with the hemorrhagic cystic portion extending to the posterior subserosal space. Following hysterectomy, the final pathological diagnosis was ETT. An ETT is essentially a solid tumor composed of intermediate trophoblasts that exhibit an epithelial-like growth pattern and contain geographic necrosis with calcification. In our case, MRI revealed a non-specific-intensity solid tumor in the lower uterine segment with massive necrosis and hemorrhage extending to the subserosa. While it is difficult to distinguish between ETT and uterine carcinomas, recognition of certain tumor shapes and necrosis could enable more accurate diagnosis before treatment.
ISSN:1347-3182
1880-2206