Primary Epithelioid Trophoblastic Tumor of the Vagina: A Case Report and Literature Review

Xinmeng Tang,1,2,* Zhen Ren,1,2,* Chengchao Du,1,3 Yonghua Xu,4 Honggui Zhou1 1Department of Gynecology and Obstetrics, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People’s Republic of China; 2School of Clinical Medicine, North Sichuan Medical College, Nanchong, Sichuan, People’s Republic of China; 3North Sichuan Medical College Innovation Centre for Science and Technology, Nanchong, Sichuan, People’s Republic of China; 4Department of Imaging and Interventional Radiology, Zhongshan-Xuhui Hospital of Fudan University, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Honggui Zhou, Department of Gynecology and Obstetrics, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People’s Republic of China, Email [email protected]: Primary vaginal epithelioid trophoblastic tumor (ETT) is an exceptionally rare malignant gestational trophoblastic neoplasm.Case Presentation: A 51-year-old woman presented with irregular vaginal bleeding and elevated serum β-hCG levels. Examination revealed a vaginal wall mass, and local excision confirmed the diagnosis of ETT. The patient completed seven cycles of chemotherapy and was under regular surveillance thereafter. One year later, local recurrence was detected at the primary tumor site. Definitive surgical intervention was then performed, comprising subradical hysterectomy, bilateral salpingo-oophorectomy, and resection of the recurrent vaginal tumor, which was also histopathologically confirmed to be an ETT. Postoperative adjuvant chemotherapy was initiated. The patient has remained disease-free during the subsequent follow-up period.Conclusion: This case demonstrates that ETT can occur primarily in the vagina, presenting as a vaginal mass with elevated serum β-hCG levels. Therefore, clinicians should include ETT in the differential diagnosis of such cases. Our experience suggests that chemotherapy alone may be insufficient to prevent disease recurrence and that a multimodal treatment strategy centered on complete surgical resection and vigilant surveillance may be effective in achieving long-term remission.Keywords: ETT, β-hCG, diagnosis, treatment, follow-up