Analysis Of Clinical Features Of Epithelioid Trophoblastic Tumor And Literature Review

ObjectiveTo analyze the clinical features of epithelioid trophoblastic tumors and to summarize the characteristics of cases with only isolated lung lesions and no reproductive system lesions.MethodsA retrospective study was performed on 8 patients who were diagnosed ETT and treated between June 2013 to June 2018.The literature review d 7 cases of epithelioid trophoblastic tumors with only pulmonary lesions and no reproductive system lesions.Result1.The average age of 8 patients with ETT was 30 years old.All of them had a history of pregnancy with average pregnancy 2 times.The average interval from the previous pregnancy was 44.8 months.Vaginal bleeding and abnormal HCG elevation were common clinical symptom.Most patients(7/8)had blood HCG peaks below 2500 IU/L with one case secondary to choriocarcinoma chemotherapy.And the peak HCG was 6587IU/L.2 patients were admitted to hospital with "ectopic pregnancy" and"cesarean section scar pregnancy" with other patients diagnosed with "gestational trophoblastic tumor".There were 3 patients in stage I and 5 in stage III.All patients were diagnosed by pathology as well as immunohistochemical staining.Six patients underwent surgical treatment with fertility preservation and two patients underwent hysterectomy.Seven patients received chemotherapy.2.Seven cases of ETT cases with only isolated pulmonary lesions were included in the Literature review.The average age of the group was 36.Vaginal bleeding or menstrual abnormalities were common symptoms,accounting for 4/7.And some patients are asymptomatic.Serum HCG levels ranged from 400-1100 mIU/m in all patients.All patients were received pulmonary lesion resection.Some patients(4/7)underwent hysterectomy or chemotherapy.ConclusionWhen a fertile age woman persistently shows abnormal low-level escalation of HCG,especially lung X-rayor CT showing lesions without apparent abnormality of the uterus,ETT should be be taken into consideration,despite no manifested vaginal bleeding,cough,hemoptysis,and other symptoms and signs.For patients with HCG abnormalities,close follow-up is required.If the blood HCG is more than 200 U/L,it is likely to be a persistent hydatidiform mole or gestational trophoblastic tumor.Extrauterine isolated lesions resection combined with chemotherapy made it possible for young ETT patients with limited lesions to reserve fertility.