Carcinosarcoma arising from atypical endometriosis in a cesarean section scar

Abstract

Malignant change of endometriosis in a cesarean scar (CS) is rare. We report a case of carcinosarcoma arising from atypical endometriosis in a CS scar, which was successfully treated with complete excision of the lesion and repair of the abdominal wall defect with autologous skin-muscle flap graft. A 41-year-old woman presented with a recurrent endometriosis in a CS scar. Within 16 years it changed from benign to atypical endometriosis and finally to carcinosarcoma after three operations. Complete excision of the tumor was performed, with a big defect of abdominal wall successfully repaired by autologous pedicle skin-muscle graft. The diagnosis of carcinosarcoma arising from atypical endometriosis was confirmed histologically. The lesion recurred 6 months after the fourth operation. She died of disease 15 months after the fourth operation. This case demonstrated that long-standing recurrent scar endometriosis could undergo malignant changes and should be made aware. The primary treatment is complete surgical excision.

Malignant transformation of abdominal wall endometriosis to clear cell carcinoma: case report and review of the literature

“…The malignant transformation of abdominal wall endometriosis is rare: few cases have been reported in the literature (Table 1) (4,(6)(7)(8)(9)(10)(11)(12)(13).…”

“…Chemotherapy (10,13) and radiotherapy (7, 10-12) have been proposed, but there is no evidence to suggest that they improve prognosis. Of the 10 patients with malignant transformation of abdominal wall endometrioma described in the literature, 4 died from the disease; a variety of different treatment protocols were used (surgery and radiotherapy; surgery, chemotherapy, and radiotherapy; surgery alone; and surgery and chemotherapy) (7,10,12,13).…”

Abdominal wall endometriosis: an update in clinical, imagistic features, and management options

“…Clear cell carcinoma is the most common histological sub type, and the 20-month survival rate is only 57% [61]. Several other types have been sporadically reported in the literature, including carcinosarcoma, cystadenocarcinoma, and serous papillary carcinoma [62][63][64]. The main prevention method is represented by wide excision of AWE with clear margins.…”

Endometriosis De La Pared Abdominal

“…La incidencia se ha reportado entre 0,3 y 1% (23,24,25). La transformación maligna es un evento raro, descrito principalmente complicando endometriosis ovárica, pero debe ser reconocida como una posibilidad en el diagnóstico diferencial de masas de la pared abdominal.…”