April 4th, 2020

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Single-Center Experience in Managing Epithelioid Trophoblastic Tumors
Authors:  Lawrence H. Lin, M.D., Koji Fushida, M.D., Ph.D., Maria Okumura, M.D., Ph.D., Regina Schultz, M.D., Ph.D., Rossana P. V. Francisco, M.D., Ph.D., and Marcelo Zugaib, M.D., Ph.D.
  OBJECTIVE: To describe the experience in managing patients with epithelioid trophoblastic tumor (ETT) in a single institution.

STUDY DESIGN: This is a retrospective case series of patients diagnosed with ETT at the University of Sao Paulo Trophoblastic Disease Center from January 2001 to December 2016.

RESULTS: During the study period, 8 patients with ETT were identified. Patient characteristics were as follows: all patients were of reproductive age, the last gestation in 75% was a hydatidiform mole, the interval from the last pregnancy ranged from 3–48 months, and the median human chorionic gonadotropin (hCG) level was 119 mIU/mL. Six patients presented with stage I disease; 5 of them were treated with hysterectomy and chemotherapy and 1 was treated with hysterectomy alone. One patient presented with a lung nodule and was treated with pulmonary resection and chemotherapy. These 7 patients were followed and had no recurrence. The only patient who died presented with stage IV disease, which did not respond to chemotherapy.

CONCLUSION: ETT is a rare form of trophoblastic tumor which presents with low levels of hCG for tumor volume. This case series highlights the importance of surgical management of confined diseases, since ETT is poorly responsive to chemotherapy.
Keywords:  epithelioid trophoblastic tumor, gestational trophoblastic disease, trophoblastic neoplasms
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