Malignant transformation of endometriosis in a laparoscopic trocar site a case report

Abstract

Background Malignant transformation of endometriosis is infrequent at the laparoscopic trocar site. Although malignant transformation is uncommon, it must be acknowledged in order to achieve radical resection. Case presentation We report on a 54-year-old woman with trocar site endometriosis 2 years after laparoscopic ovarian endometrial resection. Physical examination revealed a subcutaneous solid tumor with a diameter of 3 cm surrounding the scar of laparoscopic surgery in the right lower abdomen. Transabdominal ultrasonography showed a cystic tumor in the subcutaneous adipose layer of the right lower abdomen. The pathological diagnosis was poorly differentiated endometrioid carcinoma. Hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy were then performed. Histological examination revealed mixed endometrioid carcinoma and clear cell carcinoma. After six cycles of chemotherapy, computed tomography showed no signs of recurrence. Conclusions Malignant transformation of laparoscopic endometriosis is very uncommon, and the diagnosis and stage are determined by clinical manifestations and imaging examination. The main therapy methods are radical surgery combined with neoadjuvant chemotherapy and adjuvant radiotherapy. At the same time, reducing iatrogenic abdominal incision implantation is an effective prevention method.

Malignancy in Abdominal Wall Endometriosis: Is There a Way to Avoid It? A Systematic Review

“…Locally advanced cancer at the time of diagnosis can explain the poor prognosis of malignant AWE [17]. Some authors describe other prognostic factors such as the size of the mass at the time of diagnosis, which could play a role in a better outcome, especially if the masses range between 4 and 9 cm [63][64][65][66][67][68][69][70][71][72][73][74].…”