Clear cell adenocarcinoma of the peritoneum: a case report and literature review

Abstract

Clear cell adenocarcinoma (CCC) is generally thought to originate from ovarian, endometrial, or renal tissue. A CCC of the peritoneum (CCAP) is an extremely rare medical condition and is associated with a poor prognosis. To date, only 10 cases of CCAP have been reported, of which half resulted in death or recurrence within 6 months after initial treatment because CCAP is commonly resistant to multiple drugs. In this report, we present a case of CCAP of the pouch of Douglas coexisting with an endometriosis and we offer a review of the related literature.

Cutaneous and Cerebral Metastases From Primary Peritoneal Clear Cell Carcinoma

“…In particular, clear cell carcinoma of the ovary and those few reported primary extraovarian peritoneal carcinomas are often associated with endometriosis [11]. In the present case, our patient had evidence of endometriosis and adenomyosis on vaginal ultrasound and in the final histological analysis and, according to the previous 13 cases reported in the literature, approximately one-third had a previous gynecological record of endometriosis [1,3,10]. Endometriosis is one of the most common types of gynecologic disorders with an estimated incidence that ranges from 7% to 10% [4].…”

“…Differentiating tumors originating primarily from the peritoneum versus tumors originating from the ovary can be very difficult [1]. The Gynecology Oncology Group (GOG) criteria establish the diagnosis of primary peritoneal tumors as follows: "ovaries should be of normal size bilaterally or enlarged by benign processes plus the involvement in extraovarian locations should be larger than that on both ovaries", this is originally described for primary adenocarcinoma of the peritoneum [1,10]. The pathological process of development of peritoneal serous carcinoma resembles to that of ovarian cancer and it may develop from the remnants of ovarian tissue in the peritoneum during embryonic development or from the mesoderm that originates the epithelium of the ovary and the peritoneum [10].…”

“…The Gynecology Oncology Group (GOG) criteria establish the diagnosis of primary peritoneal tumors as follows: "ovaries should be of normal size bilaterally or enlarged by benign processes plus the involvement in extraovarian locations should be larger than that on both ovaries", this is originally described for primary adenocarcinoma of the peritoneum [1,10]. The pathological process of development of peritoneal serous carcinoma resembles to that of ovarian cancer and it may develop from the remnants of ovarian tissue in the peritoneum during embryonic development or from the mesoderm that originates the epithelium of the ovary and the peritoneum [10]. Therefore, pelvic/abdominal mesothelium may be the origin of primary peritoneal carcinoma similar to ovarian cancer and additionally, non-serous peritoneal carcinoma has been described, such as PPCCC [10].…”

“…The pathological process of development of peritoneal serous carcinoma resembles to that of ovarian cancer and it may develop from the remnants of ovarian tissue in the peritoneum during embryonic development or from the mesoderm that originates the epithelium of the ovary and the peritoneum [10]. Therefore, pelvic/abdominal mesothelium may be the origin of primary peritoneal carcinoma similar to ovarian cancer and additionally, non-serous peritoneal carcinoma has been described, such as PPCCC [10]. The pathogenesis of non-serous carcinomas has been ascribed to the existence of an extraovarian extended Mullerian system or to peritoneal endometriosis.…”

Primary diaphragmatic clear cell carcinoma associated with endometriosis: A case report and literature review

“…The origin of CCCs in the peritoneum and diaphragm is currently thought to be associated with Müllerian metaplasia and endometriosis. To our knowledge 15 cases of primary peritoneal or diaphragmatic CCCs have previously been reported, and they are summarized in Table 1 ( Terada and Kawaguchi, 2005 , Takano et al, 2009 , Fujiu et al, 2010 , Harimoto et al, 2018 , Shigeta et al, 2014 , Insabato et al, 2015 , Peiro et al, 2020 ). Only two cases of diaphragmatic CCC were identified ( Fujiu et al, 2010 , Harimoto et al, 2018 ).…”