Surgery of abdominal wall endometriosis associated with clear-cell carcinoma: Case report and review

J Gynecol Obstet Hum Reprod. 2023 Apr;52(4):102561. doi: 10.1016/j.jogoh.2023.102561. Epub 2023 Feb 24.

Abstract

Abdominal wall is a rare location for endometriosis, with a reported incidence of parietal endometriosis of approximately 0.03 to 0.4%. It most often occurs in the aftermath of a caesarean section and is associated with pelvic endometriosis in only 5 to 15% of cases. Rare cases of malignant transformation have been described, mainly in the form of clear-cell tumours. We report the case of a 52-year-old patient with a history of endometriosis who presented with a retractile parietal mass at the level of her caesarean scar. Histological analysis confirmed a clear-cell adenocarcinoma (CCC). Few cases of endometriosis - associated CCC are described in the literature. A review of the literature suggests radical surgical treatment combined with adjuvant radio-chemotherapy. However, the prognosis is poor. The aim of this case report is to suggest the diagnosis of malignant transformation in the presence of a rapidly evolving parietal mass in the context of endometriosis and a history of caesarean section.

Keywords: Caesarean-section scar; Clear-cell carcinoma; Parietal endometriosis.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Abdominal Wall* / pathology
  • Abdominal Wall* / surgery
  • Adenocarcinoma, Clear Cell* / complications
  • Adenocarcinoma, Clear Cell* / surgery
  • Cell Transformation, Neoplastic / pathology
  • Cesarean Section / adverse effects
  • Endometriosis* / complications
  • Endometriosis* / pathology
  • Endometriosis* / surgery
  • Female
  • Humans
  • Middle Aged
  • Pregnancy
  • Prognosis