High-risk HPV associated carcinoma with trophoblastic differentiation. A case report highlighting features of an aggressive somatic malignancy with elevated BHCG levels

We report a case of a poorly differentiated somatic carcinoma with trophoblastic differentiation of the cervix in a 29-year-old woman. Her recent antecedent pregnancy, rising serum Beta-Human Chorionic Gonadotropin titres and cervical based site raised the possibility of a non-choriocarcinomatous gestational trophoblastic neoplasm. The available tumor morphology, although not classic, was suggestive of epithelioid trophoblastic tumor (ETT). Immunohistochemistry was equivocal in separating the two differential diagnoses of a carcinoma with trophoblastic differentiation versus an ETT. Genotypic analysis revealed that the tumor harboured an identical genetic profile to that of the normal tissue, excluding the possibility of an ETT. High-risk human papilloma virus (HPV) testing using a highly sensitive real-time PCR method confirmed the presence of an HPV16 subtype. We concluded that the tumor represents a poorly differentiated HPV associated squamous cell carcinoma.