A 32-year-old woman underwent a suction curettage for missed abortion. The initial serum human chorionic gonadotropin (β-hCG) level was 40 IU/ml. The histologic examination of the uterine curettage specimen showed scant strips of a poorly differentiated malignant neoplasm and no chorionic villi. The tumor showed strong immunoreactivity for cytokeratin (AE1/AE3) and β-hCG but no reactivity for human placental lactogen. The combination of histologic appearance, β-hCG immunoreactivity, and elevation of serum β-hCG raised a strong suspicion for epithelioid trophoblastic tumor (ETT). Postcurettage serial serum β-hCG levels remained in the range of 20 to 45 μg/ml. Computerized tomographic scan showed a 1.0-cm circumscribed mass in the upper endocervix. A radical hysterectomy and pelvic lymphadenectomy were performed. Gross examination of the hysterectomy specimen likewise showed a well- circumscribed mass in the upper endocervix. Histologic examination revealed an undifferentiated carcinoma accompanied by intense lymphoplasmacytic infiltrate. A final diagnosis of lymphoepithelioma-like carcinoma (LELC) was rendered. LELC with elevated serum β-hCG level and immunoreactivity to β- hCG should be distinguished from ETT in a small endocervical curettage sample.
- Lymphoepithelioma-like carcinoma
- Uterine cervix
ASJC Scopus subject areas
- Pathology and Forensic Medicine
- Obstetrics and Gynecology