Journal of Clinical Gynecology and Obstetrics, ISSN 1927-1271 print, 1927-128X online, Open Access
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Case Report

Volume 12, Number 3, December 2023, pages 117-122

Sal-Like Protein 4-Negative Gestational Trophoblastic Neoplasia

Figures

Figure 1.
Figure 1. Transvaginal ultrasonography showed a 26 × 17 mm hyperechoic mass in the uterus; sagittal plane (a) and transverse plane (b).
Figure 2.
Figure 2. Macroscopic findings revealed a 2-cm dark red nodule protruding into the uterine cavity from the fundus.
Figure 3.
Figure 3. Hematoxylin and eosin staining showed prominent atypical cells arranged in biphasic proliferation of syncytiotrophoblasts and cytotrophoblasts, infiltrating the muscle layer in a sheet-like form, with hemorrhage and necrosis. Tumor cells showed marked cytologic atypia, with a high mitotic count of 15 - 17 mitoses/10 high-power fields (HPFs).
Figure 4.
Figure 4. Immunohistochemical staining of atypical trophoblast cells. Ki-67 was expressed in 50-90% of tumor cells (a). Tumor cells were positive for CAM5.2 (b), weakly diffusely and strongly positive in partial for hCG (c), positive for hPL (d), negative for p63 (e), and negative for SALL4 (f); positive control for SALL4 in a case of adenocarcinoma with enteroblastic differentiation (g). hCG: human chorionic gonadotropin; hPL: human placental lactogen; SALL4: Sal-like protein 4.