Clear cell carcinoma arising from abdominal wall endometriosis – Brief report and review of the literature

Marques, Cecília; Silva, Teresa S.; Figueiredo-Dias, Margarida

doi:10.1016/j.gore.2017.03.008

Cited by 20 publications

(22 citation statements)

References 11 publications

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“…Endometriosis has been identified as a precursor of clear cell carcinoma, which presumably accounts for the higher incidence of this histologic subtype ( Taburiaux et al, 2015 ). The precipitant of the neoplastic event in the current study remains idiopathic, although one may conjecture that genetics, immunological or hormonal factors were contributing factors ( Marques et al, 2017 ). We can ultimately preclude the influence of estrogen therapy since the patient did not have a history of taking this medication.…”

Section: Discussionmentioning

confidence: 75%

“…Surgical treatment has reportedly been comprised of local resection, total abdominal hysterectomy or salpingo-oophorectomy ( Ijichi et al, 2014 ). In addition to definitive surgery, a regimen of carboplatin and paclitaxel has been considered effective at treating this malignancy ( Marques et al, 2017 ). Radiotherapy has also been reportedly beneficial in combination with platinum-based therapy for the treatment of endometriosis related cases of malignant transformation ( Mihailovici et al, 2017 ); moreover, radiotherapy is potentially indicated when addressing metastatic disease ( Macrie et al, 2014 ).…”

Section: Discussionmentioning

confidence: 99%

“…Endometriosis has been described in patients with a history of gynecologic surgery, namely following a caesarean section ( Horton et al, 2008 ). Nevertheless, it is quite unusual to encounter a carcinoma originating from endometriosis in the abdominal wall ( Marques et al, 2017 ; Taburiaux et al, 2015 ), let alone the pelvic side wall. Herein, we review a patient with clear cell carcinoma of the pelvic side wall, stemming from endometriosis.…”

Section: Introductionmentioning

confidence: 99%

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Clear cell carcinoma of the pelvic side wall arising from endometriosis

Abaid

Cupp

Chang

et al. 2018

Gynecologic Oncology Reports

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Endometriosis is a condition wherein an ectopic layer of endometrial tissue arises in an extra-uterine location, often effecting significant pelvic pain and infertility. While very uncommon, there have been reported cases of endometriosis undergoing malignant transformation, frequently involving the ovaries and seldom in extra-gonadal regions. We recount a case depicting a 63 year-old woman who presented with an apparent inguinal hernia in 2017; she was ultimately diagnosed with a pelvic side wall clear cell carcinoma and attendant metastatic disease to the medial groin, which emanated from endometriosis. Malignant transformation of endometriosis identified in the pelvic side wall is a very rare finding. Nevertheless, oncologists should maintain a high index of suspicion in patients with a history of endometriosis or pelvic surgery.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clear cell carcinoma of the pelvic side wall arising from endometriosis

Abaid

Cupp

Chang

et al. 2018

Gynecologic Oncology Reports

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“…Adjuvant chemotherapy and radiotherapy have been reported to improve outcomes, although no consensus is established regarding protocols. Although CCC shows poor chemosensitivity, a combination of carboplatin and paclitaxel has been reported as the preferable regime (39). The prognosis of these patients is quite poor; the median survival time is about 30 months (44).…”

Section: Discussionmentioning

confidence: 99%

Endometriosis-associated Clear Cell Carcinoma of the Abdominal Wall After Caesarean Section: A Case Report and Review of the Literature

Giannella¹,

Serri²,

Maccaroni³

et al. 2020

In Vivo

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Background/Aim: Clear cell carcinoma of the abdominal wall is a sporadic event. To date, about thirty cases have been reported in the literature. This article provides a case report and literature review of an infrequent occurrence with poor prognosis. Case Report: A 45-year-old woman with pelvic pain and an abdominal mass came to our attention. Her medical history was notable for two previous cesarean sections. Physical examination revealed a smooth, multilocular mass measuring about 20 cm, arising from the previous surgical scar. Histology revealed clear-cell carcinoma resulting from the transformation of abdominal wall endometriosis. Given the disease extent, the patient underwent front-line chemotherapy. After several and multiple chemotherapy regimens, there was a disease progression that resulted in the death of the patient in 7 months. The literature review showed that a previous cesarean section was present in 91% of cases. Besides, approximately 26.5% of women died within 12 months of being diagnosed. The mean age of women was 45.88 years, while the average size of the lesion was 11 cm. Conclusion: Clear cell carcinoma is a rare but occurring event. Middleaged women showing an abdominal wall mass in close relation with a surgical scar from a previous cesarean section must be promptly investigated. Treatment options usually include surgery and chemotherapy with poor results. Endometriosis is defined as an inflammatory disease characterized by the presence of a functioning endometrial gland and stroma outside the uterus (1). These lesions usually involve the ovaries and, more rarely, bowel, ureters, lung, and abdominal wall (1). In women with abdominal wall endometriosis (AWE), a prior history of gynecological surgery with the opening of the uterine cavity is usually found. In this regard, scar endometriosis can be explained by iatrogenic transplantation of endometrial tissue to the wound edge during the surgical procedure (2, 3). The incidence of abdominal surgical scar endometriosis ranges between 0.03% and 1.08% of women undergoing pelvic surgery (4, 5). It is often misdiagnosed and detected preoperatively in 20%-50% of cases (2). Women typically report a cyclic menstrual pain referred to the abdominal wall. The differential diagnosis of a subcutaneous mass associated with a previous surgical incision of the abdominal wall includes abscess, hematoma, hernia, desmoid tumor, sarcoma, and metastatic disease (6). An accurate medical history and physical examination can guide towards diagnosis. Definitive treatment includes wide local excision with free margins. Hormonal therapies relieve symptoms but do not prevent recurrences (6). Although endometriosis is considered a benign condition, malignant transformation is rare but possible. About 80% of endometriosis-associated malignancies have been found in the ovary, whereas 20% are localized in extra-gonadal sites (7). Clear cell histology represents 4.5% of the extra-pelvic endometriosis-associated malignancies. It represents the most common histotype in the ...

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“…Giving the increasing number of caesareans in the world it is likely that abdominal wall endometriosis also increases. 8 From January 1951 to August 2006, 29 articles describing 445 patients diagnosed with endometriosis majority of cases were associated with a caesarean scar or a gynecological surgeries, and 20% of patients had abdominal wall endometriosis not associated with scars. 9 Among gynecological procedures caesarean section greatly increases the risk of developing scar endometriosis when compared to other gynecological procedures.…”

Section: Discussionmentioning

confidence: 99%

A case series on management of scar endometriosis following C-sections

Chitrambalam¹,

Sekhar²,

Jeyakumar³

et al. 2019

Int Surg J

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Endometriosis is presence of functioning endometrial tissue outside the uterine cavity. Endometriosis can sometimes occur in a previous surgical scar. Scar endometriosis is rare and difficult to diagnose. It mostly follows obstetrical and gynecological surgeries. This condition is often confused with other surgical conditions. We are reporting 5 cases of scar endometriosis following cesarean section, some of which were misdiagnosed as stitch granuloma initially. Medical treatment was not helpful. All 5 patients required wide surgical excision of the lesion. The pathogenesis, diagnosis and treatment of this condition are being discussed.

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Clear cell carcinoma arising from abdominal wall endometriosis – Brief report and review of the literature

Cited by 20 publications

References 11 publications

Clear cell carcinoma of the pelvic side wall arising from endometriosis

Clear cell carcinoma of the pelvic side wall arising from endometriosis

Endometriosis-associated Clear Cell Carcinoma of the Abdominal Wall After Caesarean Section: A Case Report and Review of the Literature

A case series on management of scar endometriosis following C-sections

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