A case of metastatic clear cell carcinoma caused by endometriosis

ZeYu Ma, Zybina Ma, Chuangyu Huang, Mingxiao Yang, Ning Liu
In: Journal of Endometriosis and Pelvic Pain Disorders · 2025 · vol. 18(1) , pp. 62–66 · doi:10.1177/22840265251365862 · W4414831483
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This case report reviews a patient with metastatic clear cell carcinoma adjacent to the rectus muscle, finding evidence of malignant transformation of endometriosis as a potential cause despite no prior history.

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Abstract

Objective: To discuss the etiology, characteristics, and treatment strategies of metastatic clear cell carcinoma. Methods: This study retrospectively reviews a case of metastatic clear cell carcinoma adjacent to the right lower abdominal rectus muscle, managed in the Department of Gastrointestinal Surgery at Hainan Provincial People’s Hospital, combined with an analysis and discussion of relevant literature from domestic and international sources. Results: A 54-year-old female patient was admitted with a palpable mass in the lower abdomen, approximately 10 cm × 9 cm × 8 cm in size. She had a history of cesarean section 20 years ago but no history of endometriosis. Preoperative diagnosis suggested an abdominal wall mass, and the patient underwent radical resection of the abdominal wall tumor with abdominal wall defect repair. During surgery, the mass was found beside the right rectus abdominis muscle in the lower abdominal wall, measuring approximately 10 cm × 9 cm × 8 cm. Intraoperative frozen pathology suggested metastatic clear cell carcinoma, with the presence of endometrial glands, stromal cells, and hemosiderin deposition, indicating malignant transformation of endometriosis. Conclusion: This condition has a low preoperative detection rate, and early surgical treatment should be undertaken once the diagnosis is confirmed. For this patient, although there was no clear history of endometriosis, the malignant transformation of ectopic tissue may be one of the potential causes of metastatic clear cell carcinoma. Therefore, a comprehensive assessment of medical history and imaging studies should be strengthened before surgery.
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endometriosis

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