Exclusive nodal recurrence after treatment of degenerated parietal endometriosis

Abstract

Objective: To report a case of endometriosis degenerated into clear cell carcinoma with positron-emission tomography (PET) scan staging.

Design: Case report.

Setting: University hospital.

Patient(s): A 43-year-old woman diagnosed with endometriosis degenerated into clear cell carcinoma with nodal metastasis at the initial diagnosis and exclusive nodal recurrence 6 months after surgery.

Intervention(s): Resection of the mass with partial resection of the pubic symphysis and bilateral external iliac lymphadenectomy. Forty-five days later, hysterectomy with bilateral adnexectomy and then adjuvant chemotherapy and abdominal-pelvic radiotherapy.

Main outcome measure(s): The PET scan showed positive lymph nodes in the cervical, supraclavicular, bilateral axillary, bilateral inguinal, and lumbar-aortic regions.

Result(s): The patient experienced a tumor recurrence after 6 months. After surgical management, she was scheduled to receive six cycles of rescue chemotherapy. She died 22 months after the initial diagnosis.

Conclusion(s): The use of PET scan could allow better staging at the initial diagnosis and improve follow-up in such patients. The treatment of this entity is based on radical surgery associated with adjuvant chemotherapy and radiotherapy, but the results are not satisfactory.