Clear cell carcinoma arising from scar endometriosis: A case report and literature review

Abstract

Scar endometriosis is uncommon and defined as the presence of ectopic endometrial glands in abdominal soft tissues after a gynecological operation. Malignant transformation has been reported but remains rare. Carcinogenesis occurs in ectopic endometrial tissue with repeated hormone stimulation during the menstrual cycle. We present a case of clear cell carcinoma directly arising from scar endometriosis after a cesarean section and review all 16 cases reported.

Parietal Mass: Two Case Reports of Rare Cesarean Scar Endometriosis

“…An increase in the concentration of hepatocyte growth factor and a decrease in the concentration of interferon gamma-inducible protein-10 in the peritoneal fluid of women with endometriosis may stimulate angiogenesis and the development of endometriosis [10]. Some of those functional endometrial cells continue their growth and become malignant, although the overall frequency of malignant transformation from endometriosis is estimated to be up to 1% [11]. The most common type is clear-cell carcinoma with overall survival in five years estimated to be 80% [12].…”

Abdominal Wall Clear Cell Carcinoma: Case Report of a Rare Event with Potential Diagnostic Difficulties

“…Although endometriosis implants are typically observed after c-section (0.03% to 1%) or hysterectomy, they have also been reported to be associated with episiotomy, trocar scars, appendectomy, and hernia repair scars [6–8]. Malignant transformation of endometriosis associated with surgical scars is very rare, with an estimated incidence of no more than 1% [2–4, 9, 10]. CCC is the histological subtype more often present in these cases, followed by endometrioid adenocarcinoma [8].…”

Clear cell carcinoma arising from abdominal wall endometrioma after cesarean section

“…Endometriosis, which is common among women of reproductive age, suggests the presence of functioning endometrial tissues outside the uterus. 3 Patients with clear cell carcinoma arising in endometriosis often have a history of uterine surgery, especially cesarean section. The time between surgery and cancer diagnosis can vary widely among patients, for example, from 9 to 30 years post-uterine surgery.…”

“…The time between surgery and cancer diagnosis can vary widely among patients, for example, from 9 to 30 years post-uterine surgery. [1][2][3] Scar endometriosis usually results from the intra-surgical implantation of endometrial tissues into the edge of the surgical wound in the abdominal wall's soft tissues. 2 3 Symptoms suggesting endometriosis in a surgical abdominal scar from gynecologic or obstetric surgery include a slow developing lump in or near the scar, and pain and abdominal swelling during menstruation.…”

“…Case reviews usually describe using platinum-based chemotherapy ± -local radiation for adjuvant treatment. 3 The recommendation was made for the patient to undergo systemic adjuvant therapy in the form of six cycles of carboplatin and paclitaxel. Immediately before the adjuvant treatment, the serum CA125 level was 11.8 U/mL.…”