Epithelioid trophoblastic tumor of paracervix and parametrium

Epithelioid trophoblastic tumor (ETT) is an unusual variant of gestational trophoblastic tumor that is closely related to choriocarcinoma and placental site trophoblastic tumor but shows different morphologic and immunohistochemical features. We report an ETT discovered in paracervix, parametrium, and periadnexal soft tissue of a 44-year-old woman. She underwent laparoscopic surgery and four courses of chemotherapy with a regimen of etoposide, methotrexate, and dactinomycin. ETT has a distinctive growth pattern and immunohistochemical profile. The difficulties and clues in distinguishing ETT from nontrophoblastic lesions are discussed.