Isolated Clear Cell Adenocarcinoma in Scar Endometriosis Mimicking an Incisional Hernia

Harry VN, Vanessa N. Harry, Smruta Shanbhag, S Shanbhag, Shanbhag S, Lyall M, Matthew Lyall, Narayansingh GV, Gordon Narayansingh, Gordon V Narayansingh, Parkin DE, David E. Parkin
Obstetrics and gynecology · 2007 · vol. 110(2) , pp. 469–471 · doi:10.1097/01.aog.0000260393.46154.5f · PMID:17666631 · W2323175545
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-09 ⓘ

This case report describes a rare instance of clear cell adenocarcinoma arising in scar endometriosis over 30 years post-surgery, initially mimicking an incisional hernia and presenting diagnostic and surgical challenges.

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⚙ AI-generated deep summary by qwen3.7-flash, 2026-08-21 · read from full text ⓘ

This case report describes a 55-year-old woman who developed an isolated clear cell adenocarcinoma within scar endometriosis tissue more than three decades after undergoing open tubal sterilization. The mass initially presented as a suspected incisional hernia, leading to diagnostic challenges that were only resolved through intraoperative frozen section analysis and subsequent surgical excision. The authors highlight the rarity of malignant transformation in this context and emphasize the need for clinical vigilance when evaluating masses near surgical scars to ensure appropriate suspicion and management. This paper is centrally about endometriosis — specifically the rare malignant degeneration of scar endometriosis into clear cell adenocarcinoma.

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Abstract

In Brief BACKGROUND: The development of a mass in association with a previous surgical scar can pose a diagnostic dilemma due to similarities in appearance to hernias, abscesses, hematomas, or desmoid tumors. Scar endometriosis is an uncommon cause of such a lump, but malignant change within this ectopic tissue is exceptionally rare. CASE: We present a case of a 55-year-old woman who was found to have an isolated clear cell adenocarcinoma in an area of scar endometriosis more than 30 years after an open tubal sterilization. This mass was initially thought to be an incisional hernia, but was later diagnosed intraoperatively by frozen section and then incompletely excised, highlighting the difficulties in preoperative diagnosis as well as surgical treatment. CONCLUSION: Malignant change within scar endometriosis is rare, but increased awareness of this phenomenon is required. Vigilance is paramount and a mass located in or close to a surgical scar should be treated with suspicion. Scar endometriosis should be considered in the differential diagnosis of a mass associated with a surgical scar, and awareness of the possibility of malignant change is required.
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Background

The development of a mass in association with a previous surgical scar can pose a diagnostic dilemma due to similarities in appearance to hernias, abscesses, hematomas, or desmoid tumors. Scar endometriosis is an uncommon cause of such a lump, but malignant change within this ectopic tissue is exceptionally rare. CASE: We present a case of a 55-year-old woman who was found to have an isolated clear cell adenocarcinoma in an area of scar endometriosis more than 30 years after an open tubal sterilization. This mass was initially thought to be an incisional hernia, but was later diagnosed intraoperatively by frozen section and then incompletely excised, highlighting the difficulties in preoperative diagnosis as well as surgical treatment.

Conclusion

Malignant change within scar endometriosis is rare, but increased awareness of this phenomenon is required. Vigilance is paramount and a mass located in or close to a surgical scar should be treated with suspicion.

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Condition tags

endometriosis

MeSH descriptors

Adenocarcinoma, Clear Cell Cicatrix Endometrial Neoplasms Endometriosis Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Cicatrix Cicatrix Cicatrix Diagnosis, Differential Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometriosis Endometriosis Endometriosis Female Hernia Hernia

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (17)

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