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Syncytiotrophoblastic giant cells can be seen in rare cases of high-grade urothelial carcinoma. The focus shown here was strongly positive for //BETA-HCG immunostain confirming the diagnosis. Rare cases have been associated with excess //BETA-HCG production resulting in symptoms like gynecomastia. Trophoblastic differentiation in urothelial carcinoma is associated with poor prognosis and should be mentioned in the pathology report.