Early abdominal incision recurrence in a patient with stage I adenocarcinoma of the endometrium

Chen CC, Chi Chiung Grace Chen, J. Michael Straughn, Straughn JM Jr, Kilgore LC, Larry C. Kilgore
Obstetrics and gynecology · 2004 · vol. 104(5) , pp. 1170–1172 · doi:10.1097/01.aog.0000123268.57857.0d · PMID:15516440 · W2079156228
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A patient with stage Ib endometrial adenocarcinoma and stage IV endometriosis developed rapid recurrence of the primary tumor at her abdominal incision site six months after surgery.

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This case report describes a 51-year-old woman with stage Ib grade 2 endometrial adenocarcinoma and concurrent stage IV endometriosis who developed a mass at her Maylard incision site six months after surgical staging. Imaging revealed no distant metastasis, and resection of the abdominal wall mass confirmed it as a recurrence of the primary endometrial adenocarcinoma. The authors highlight this unusual presentation to emphasize the importance of evaluating suspicious masses early in the postoperative period, even when systemic disease appears absent. This paper is centrally about adenomyosis/endometriosis contextually, as the patient’s history of severe endometriosis is a key clinical feature alongside the primary focus on endometrial cancer recurrence.

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Abstract

BACKGROUND: Although most patients with a surgical stage I endometrial cancer have an excellent prognosis, some patients will experience a recurrence. Endometrial cancer typically recurs at the vaginal cuff or in the pelvis; however, it can recur distantly in the abdomen or lung. Although recurrences have been reported at laparoscopic trochar sites, it is unusual to have a recurrence in the abdominal incision after laparotomy. CASE: A 51-year-old woman was diagnosed with stage Ib grade 2 adenocarcinoma of the endometrium and stage IV endometriosis. Six months after surgery, she presented with a mass in the lateral aspect of her Maylard incision. Computed tomography scans of the chest, abdomen, and pelvis showed no evidence of recurrent disease. The mass was resected and confirmed to be an adenocarcinoma similar to the endometrial primary. CONCLUSION: This case is interesting because of the rapid recurrence of the endometrial primary at an unusual site-the abdominal incision. It illustrates the need to carefully evaluate all suspicious masses, even as early as 6 months after diagnosis and surgical staging.
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Background

Although most patients with a surgical stage I endometrial cancer have an excellent prognosis, some patients will experience a recurrence. Endometrial cancer typically recurs at the vaginal cuff or in the pelvis; however, it can recur distantly in the abdomen or lung. Although recurrences have been reported at laparoscopic trochar sites, it is unusual to have a recurrence in the abdominal incision after laparotomy. CASE: A 51-year-old woman was diagnosed with stage Ib grade 2 adenocarcinoma of the endometrium and stage IV endometriosis. Six months after surgery, she presented with a mass in the lateral aspect of her Maylard incision. Computed tomography scans of the chest, abdomen, and pelvis showed no evidence of recurrent disease. The mass was resected and confirmed to be an adenocarcinoma similar to the endometrial primary.

Conclusion

This case is interesting because of the rapid recurrence of the endometrial primary at an unusual site—the abdominal incision. It illustrates the need to carefully evaluate all suspicious masses, even as early as 6 months after diagnosis and surgical staging.

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Condition tags

endometriosis

MeSH descriptors

Adenocarcinoma Adenocarcinoma Endometrial Neoplasms Endometrial Neoplasms Neoplasm Recurrence, Local Neoplasm Seeding Neoplasm Seeding Adenocarcinoma Adenocarcinoma Biopsy, Needle Biopsy, Needle Endometrial Neoplasms Endometrial Neoplasms Female Female Follow-Up Studies Follow-Up Studies Humans Humans Hysterectomy

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