Atypical postcesarean epithelioid trophoblastic lesion with cyst formation: A rare case report with review of literature

We report an extremely rare case of atypical epithelioid trophoblastic lesion arising from cesarean section scar in a 27-year-old woman with a history of undergoing cesarean delivery 2 years back. The patient presented with amenorrhea and increased frequency of micturition and negative urine pregnancy test. MRI was suggestive of a thin-walled exophytic hemorrhagic cyst arising from the anterior wall of lower uterine segment, communicating with the endometrial cavity. Cyst was excised and histology indicated a lesion consisting of epithelioid trophoblastic cells with an intermediate pattern between a classical placental site nodule and an epithelioid trophoblastic tumor. Immunohistochemistry revealed positivity for CK18, PLAP, and p63. Beta HCG was negative and Ki-67 index was 8%–10%.