PMC2782171_01
Fingernail sized erythematous nodules. (A) left side of neck, (B) right side of upper back.
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F1
Subjective symptoms such as pruritus or tenderness were not present (Fig. 1).
(A) Several hemorrhagic foci and multiple cellular infiltration throughout the dermis (hematoxylin and eosin, x40). (B) Infiltrated tumor cells are composed of two populations of cells. One element exhibits clear cytoplasm and large, vesicular nuclei with prominent nucleoli, which is identified as cytotrophoblasts. The other cell population shows eosinophilic cytoplasm with cytoplasmic vacuoles and many dark nuclei, which is identified as syncytiotrophoblasts (hematoxylin and eosin, x200). (Inset) hCG was positively stained in the cytoplasm of syncytiotrophoblasts but not the cytotrophoblasts (hCG stain, x400).
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F2
At low magnification, there were several hemorrhagic foci and multiple cellular infiltrations throughout the dermis (Fig. 2A). The other cell population showed eosinophilic cytoplasm with cytoplasmic vacuoles and many dark nuclei, which were identified as syncytiotrophoblasts (Fig. 2B). The immunohistochemical staining for hCG antigen (1:600, Polyclonal rabbit, Dakocytomation, Denmark) in the cytoplasm of syncytiotrophoblasts (Fig. 2B inset) was strongly positive, confirming the diagnosis of metastatic choriocarcinoma.
Abdomen pelvis MR images shows a protruding mass from low uterine cavity to vaginal canal (short arrow) and diffuse enlargement of uterus body showing heterogenous signal intensity, suggesting myometrial invasion (long arrow).
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F3
Magnetic resonance (MR) images of the abdomen-pelvis detected diffuse enlargement of the uterus body and a protruding mass in the uterine cavity, which was the primary origin of the tumor (Fig. 3).