Laparoscopic diagnosis and treatment of an isolated epithelioid trophoblastic tumor in recto ‐uterine pouch

Abstract A 30‐year‐old Chinese woman with irregular vaginal bleeding was admitted to our department. Serum β‐human chorionic gonadotropin (β‐hCG) was moderately elevated, and ultrasound and magnetic resonance imaging revealed an irregular, retro‐uterine lesion without intrauterine pregnancy. Ectopic pregnancy was the primary consideration, with trophoblastic tumor being another possibility. Laparoscopy revealed a 2 × 3 × 3 cm3 irregular, infiltrating, yellow‐white lesion in the left recto‐uterine pouch, which was completely resected without rectal damage. Final pathological/immunohistochemical analyses revealed an epithelial trophoblastic tumor (ETT) (Ki‐67 reactive index~45%). Postoperative recovery was smooth, and the patient received three chemotherapy courses (etoposide, methotrexate and actinomycin, alternating weekly with cyclophosphamide and vincristine) beginning 6 days postsurgery (β‐hCG = 46.4 mIU/mL). β‐hCG returned to an undetectable level after one chemotherapy course. Herein, we describe a rare case of isolated ETT that was difficult to differentiate from other pregnancy‐related diseases. Laparoscopy could be an effective, safe diagnostic method in select patients.
Source: Journal of Obstetrics and Gynaecology Research - Category: OBGYN Authors: Tags: Case Report Source Type: research