{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T11:58:08Z","timestamp":1790769488572,"version":"4.1.0"},"reference-count":31,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100016359","name":"Zhongnan Hospital of Wuhan University Science, Technology and Innovation Seed Fund","doi-asserted-by":"publisher","award":["CXPY2020028"],"award-info":[{"award-number":["CXPY2020028"]}],"id":[{"id":"10.13039\/501100016359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018806","name":"Natural Science Foundation of Hubei Province","doi-asserted-by":"publisher","award":["2022CFB695"],"award-info":[{"award-number":["2022CFB695"]}],"id":[{"id":"10.13039\/501100018806","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: Pulmonary epithelioid trophoblastic tumor (ETT) without demonstrable uterine involvement is an exceedingly rare form of gestational trophoblastic neoplasia. Its non-specific presentation often results in misdiagnosis, commonly as ectopic pregnancy. Case Presentation: A 39-year-old woman, para 2, presented with abnormal uterine bleeding and an elevated serum \u03b2-human chorionic gonadotropin (\u03b2-hCG) level of 978 mIU\/mL. Despite the absence of sonographic evidence for either intrauterine or ectopic pregnancy, she was initially misdiagnosed with ectopic gestation. Following a failed systemic methotrexate therapy, she underwent a non-diagnostic laparoscopic bilateral salpingectomy and curettage; however, her \u03b2-hCG levels continued to rise persistently. A computed tomography (CT) scan performed one month later revealed a solitary mass measuring 57 \u00d7 40 mm in the right lower lobe of the lung. A multidisciplinary team subsequently decided on a right lower lobectomy. Postoperatively, the patient\u2019s \u03b2-hCG levels normalized rapidly. Histopathological examination of the lung mass confirmed the diagnosis of pulmonary ETT without demonstrable uterine involvement. She received 3 cycles of combination EMA\/Co chemotherapy (etoposide, methotrexate, and actinomycin D, followed by cyclophosphamide and vincristine), and the serum \u03b2-hCG level dropped to normal. At the 3-year posttreatment follow-up, the patient reported regular menstrual cycles, with serum \u03b2-hCG levels consistently within normal limits. Conclusions: This case highlights that persistent elevation of \u03b2-hCG in the absence of pelvic pathology should prompt a comprehensive investigation for an extrauterine source. Pulmonary ETT must be included in the differential diagnosis for reproductive-aged women presenting with a pulmonary mass and elevated \u03b2-hCG levels. A multidisciplinary approach enabled both definitive diagnosis and fertility-sparing management in this patient; broader conclusions about treatment efficacy await larger series.<\/jats:p>","DOI":"10.3390\/jcm15197578","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:14:37Z","timestamp":1790694877000},"page":"7578","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pulmonary Epithelioid Trophoblastic Tumor Without Demonstrable Uterine Involvement: A Case Report and Literature Review Highlighting Diagnostic Challenges and Multidisciplinary Management"],"prefix":"10.3390","volume":"15","author":[{"given":"Kai","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang District, Wuhan 430071, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang District, Wuhan 430071, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingkui","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang District, Wuhan 430071, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4535-8260","authenticated-orcid":false,"given":"Jinghong","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang District, Wuhan 430071, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/j.ygyno.2011.01.002","article-title":"Increase in the incidence of gestational trophoblastic disease in The Netherlands","volume":"121","author":"Lybol","year":"2011","journal-title":"Gynecol. 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