Epithelioid Trophoblastic Tumor in Hysterectomized Postmenopausal Woman: A Case Report and Review of the Literature

BackgroundGestational trophoblastic disease (GTD) is a term used for a group of tumours including complete and partial hydatidiform mole, invasive mole, choriocarcinoma (CC), placental site trophoblastic tumour (PSTT), exaggerated placental site (EPS), placental site nodule (PSN), and epithelioid trophoblastic tumour (ETT). The most recent addition to GTD is ETT that is an uncommon but unique proliferative lesion whose features mimic those of squamous cell carcinoma (SCC). Distinct microscopical features and immunohistochemistry are helpful in the differential diagnosis. Surgery is considered as the primary treatment of this neoplasia when diagnosed in early stage, and in contrast to other trophoblastic tumors, epithelioid trophoblastic tumors are chemo-resistant in nature.PurposeThe intention is to highlight the need to include GTD as a possible cause of abnormal bleeding per vaginum/ leucorrhoea in peri- and post-menopausal women. So early diagnosis and management with proper follow-up is possible.Material and methodsWe are reporting a case of 53-year-old post-menopausal female who underwent hysterectomy for fibroid uterus and ETT was incidentally found after careful microscopical and immunohistochemical analysis. After the definitive diagnosis, patient underwent completion surgery. The patient is still alive and has been disease free for 24 months.ConclusionThus, it should be kept in mind that ETT may be rarely seen in the post-menopausal women and should be considered as one of the reasons for post-menopausal bleeding or leucorrhoea. Though these tumors have a relatively benign course, metastasis and mortality have been reported, so strict surveillance is required even after completing surgical resection for early-stage disease