Clear Cell Adenocarcinoma Arising from Abdominal Wall Endometriosis

Abstract

Endometriosis is a frequent benign disorder. Malignancy arising in extraovarian endometriosis is a rare event. A 49-year-old woman is presented with a large painful abdominal wall mass. She underwent a myomectomy, 20 years before, for uterus leiomyoma. Computed tomography suggested that this was a desmoid tumor and she underwent surgery. Histological examination showed a clear cell adenocarcinoma associated with endometriosis foci. Pelvic ultrasound, computed tomography, and endometrial curettage did not show any malignancy or endometriosis in the uterus and ovaries. Adjuvant chemotherapy was recommended, but the patient was lost to follow up. Six months later, she returned with a recurrence of the abdominal wall mass. She was given chemotherapy and then she was reoperated.

Clear cell adenocarcinoma arising from endometriosis in abdominal wall cesarean section scar: a case report and review of the literature

“…Twenty‐seven cases of malignancy arising in a focus of scar endometriosis (mostly in abdominal wall), including the present case, have been reported in the literature between January 1966 and November 2011 and are summarized in Table . Of these 28 total cases, 18 showed clear cell carcinoma, 4 showed endometrioid carcinoma, 2 had papillary serous carcinoma, 1 reported carcinosarcoma and 1 reported adenocarcinoma.…”

“…In these studies, the average reported age at diagnosis was 47 years old. The great majority of cases arose at a long interval from cesarean section scars, with some exceptions: one case followed myomectomy, one case followed hysterotomy, one case followed laparotomy for uterine perforation, five cases followed episiotomy, and one followed open sterilization . Most of these procedures would allow endometrium to implant at the surgical incision site.…”

Endometriosis-associated malignant transformation in abdominal surgical scar

“…More extensive surgery was reported in 6 cases, including resection of mons pubis, [ 31 ] cystectomy, [ 29 , 36 , 44 ] and colectomy. [ 33 , 43 ]…”

Endometriosis-Associated Abdominal Wall Cancer: A Poor Prognosis?

“…In the majority of cases, a total hysterectomy was performed with bilateral salpingooophorectomy, 8,9,17,19,32 omentectomy, 12,25,29 and pelvic lymphadenectomy. 21,22,28 When hysterectomy was not performed, curettage to exclude primary endometrial carcinoma was performed. 14,17,23,26,32 Chemotherapy was administered to 74% of the patients.…”