Abstract:

Epithelioid trophoblastic tumor (ETT) is an exceedingly rare subset of gestational trophoblastic neoplasia (GTN) that typically arises in the lower uterine segment or cervix and is classically associated with a history of amenorrhea and only modestly elevated serum human chorionic gonadotropin (hCG). Because of its non-specific clinical presentation and the frequently low hCG levels, diagnosis is challenging and requires integrated evaluation of clinical history, morphology, and immunohistochemistry. We report a woman with prior amenorrhea who presented with acute life-threatening vaginal bleeding, a cervical mass, and low serum hCG. Owing to overlapping morphologic and immunophenotypic features with cervical carcinoma, the differential diagnosis was complex. After emergent uterine artery embolization, the patient underwent laparoscopic hysterectomy with bilateral salpingo-oophorectomy and achieved an excellent outcome. This case underscores the necessity of including ETT in the differential diagnosis of atypical cervical neoplasms to avoid misdiagnosis and ensure timely, effective therapy.

Key words: Trophoblastic neoplasms, Uterine hemorrhage, Uterine artery embolization, Fertility preservation, Epithelioid trophoblastic tumor