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Epithelioid trophoblastic tumor coexisting with choriocarcinoma around an abdominal wall cesarean scar: a case report and review of the literature

机译：上皮滋养细胞肿瘤与腹壁剖腹产围绕的刺槐癌共存：案例报告和文学审查

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Abstract Background Mixed gestational trophoblastic neoplasms are extremely rare and comprise a group of fetal trophoblastic tumors including choriocarcinomas, epithelioid trophoblastic tumors, and placental site trophoblastic tumors. We present a case of a patient with extrauterine mixed gestational trophoblastic neoplasm adjacent to the abdominal wall cesarean scar. On the basis of a literature review, this type of case has never been reported before due to the unique lesion location and low incidence. Case presentation Our patient was a 39-year-old Chinese woman who had a history of two cesarean sections and one miscarriage. She had a recurrent anterior abdominal wall mass around her cesarean scar, and the mass was initially suspected of being choriocarcinoma of unknown origin. The patient had concomitant negative or mildly increased serum β-human chorionic gonadotropin at follow-up and no abnormal vaginal bleeding or abdominal pain. However, she underwent local excision twice and had two courses of chemotherapy with an etoposide and cisplatin regimen. She finally opted for exploratory laparotomy with abdominal wall lesion removal, subtotal hysterectomy, bilateral salpingectomy, and left ovarian cyst resection, which showed the abdominal wall lesion, whose components were revealed by microscopy and immunohistochemical staining to be approximately 90% epithelioid trophoblastic tumors and 10% choriocarcinomas from a solely extrauterine mixed gestational trophoblastic neoplasm around an abdominal wall cesarean scar. Conclusions It is worth noting whether epithelioid trophoblastic tumor exists in the setting of persistent positive low-level β-human chorionic gonadotropin. More studies are required to provide mechanistic insights into these mixed gestational trophoblastic neoplasms.
机译：摘要背景混合的妊娠期滋养细胞肿瘤非常罕见，包括一组胎儿滋养细胞肿瘤，包括幼苗癌，上皮滋养细胞肿瘤和胎盘位点滋养细胞肿瘤。我们提出了患有腹壁剖腹瘢痕相邻的Impertuterine混合妊娠期滋养细胞的病例。在文献综述的基础上，由于独特的病变位置和低发病率，此类案例从未报告过。案例介绍我们的患者是一名39岁的中国女性，历史有两个剖宫产和一个流产。她在剖腹疤痕周围经常发生前腹部墙壁，并且最初怀疑肿块是未知起源的核心癌。患者在随访时伴随着阴性或温和的血清β-人绒毛膜促性腺激素，没有异常的阴道出血或腹痛。然而，她经历了两次局部切除两次，并有两种疗程的化疗，依托钠和顺铂方案。她终于选择了腹壁病变去除，小脑膜膜切除术，双侧裂解切除术和卵巢囊肿切除术探索剖腹产术，其显示出腹壁病变，其组分被显微镜和免疫组化染色显示为约90％上皮滋养细胞肿瘤和10腹壁剖腹产瘢痕周围的仅Imperuterine混合妊娠孕产细胞瘤中的％胆小序瘤。结论值得注意的是，在持续的正低水平β-人绒毛膜促性腺激素促性腺激素的设置中是否存在上皮滋养细胞肿瘤。需要更多的研究来为这些混合妊娠期滋养细胞肿瘤提供机械洞察力。

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