An unusual presentation of endometriosis

Saadeh, Feras Abu; Wahab, Nor Azlia Abdul; Gleeson, Noreen

doi:10.1136/bcr-2014-204270

Cited by 5 publications

(2 citation statements)

References 5 publications

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“…The occurrence of endometriosis in the vulva in our patient, which subsequently transformed to clear cell carcinoma, may have extended from the pelvis via the round ligament. Though extremely rare, the occurrence of endometriosis in the extrapelvic portion of the round ligament has been reported, and it involves the right side in more than 90% of cases [ 14 – 17 ]. One possible explanation for this rare clinical presentation is the presence of atypical lymphatic flows from the peritoneal cavity and pelvis to the right groin or nonobliteration of the parietal peritoneum accompanying the round ligament in the canal of Nuck, thereby enabling the viable endometrial tissue in the peritoneal fluid to deposit along the round ligament [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Clear Cell Carcinoma Arising in Vulvar Endometriosis

Buppasiri

Kleebkaow

Tharanon

et al. 2018

Case Reports in Pathology

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We report a case of vulvar clear cell adenocarcinoma in a woman presenting with a lump and pain in the right side of the labia majora. Three years prior to this visit, she underwent a total abdominal hysterectomy with bilateral salpingooophorectomy and excision of a labial mass. Pathological examination revealed adenomyosis and multiple leiomyomas in the uterus, endometriotic cysts in both ovaries, and foci of atypical endometriosis in the labial mass. The results of an incision biopsy performed before referral indicted only apocrine hidrocystoma. Physical examination revealed a hard mass at the right labia majora extending to the right groin. The mass seemed to be in continuity with the pubic symphysis that would require pubic bone excision and reconstruction with flap surgery to achieve complete resection. However, the patient refused such extensive surgery. Based on previous diagnosis of vulvar endometriosis, she had been treated with GnRH agonists and depot medroxyprogesterone acetate. However, the mass developed into an ulcer and increased in size. A second biopsy of the mass was undertaken, and the pathological diagnosis was clear cell carcinoma with coexisting atypical endometriosis. Computed tomography of the abdominopelvic region showed an ulcerative mass at the right labia majora and nodal metastasis at the external iliac and inguinal regions. Systemic chemotherapy was administered. The growth of the tumors stabilized during the first two cycles of chemotherapy but rapidly progressed thereafter. At 17 months after her initial presentation, the patient passed away due to the progression of the disease.

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Section: Discussionmentioning

confidence: 99%

Clear Cell Carcinoma Arising in Vulvar Endometriosis

Buppasiri

Kleebkaow

Tharanon

et al. 2018

Case Reports in Pathology

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“…However, endometriosis should also be included in the differential diagnosis of continuous painful groin mass without cyclical exacerbation 7. The direct relationship of symptoms to menstruation most often will rule out other inguinal pathologies.…”

Section: Discussionmentioning

confidence: 99%

Jack in the box: inguinal endometriosis

et al. 2015

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A 39-year-old woman with a left-sided inguinal swelling was referred to us with a diagnosis of inguinal hernia. On asking leading questions, the patient gave a typical history of cyclical pain and increased swelling during menstruation. Fine-needle aspiration biopsy revealed endometrial glands. Preoperatively, the extent of the endometriotic lesion was delineated using MRI. The lesion was approached through the patient's caesarean scar for cosmetic reasons and excised in toto. Final diagnosis was round ligament endometriosis. The patient was asymptomatic at 3, 6 and 12 months’ follow-up. This case re-emphasises the fact that endometriosis is an enigmatic disease and can be found anywhere in the body. Thus, a woman of reproductive age presenting with any cyclical symptom should be asked about its relation to her menstrual cycle.

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