Clear Cell Adenocarcinoma Arising in Endometriosis of a Previous Episiotomy Site

Yong‐Soon Kwon, Joo‐Hyun Nam, Gawon Choi
In: Obstetrics & Gynecology · 2008 · vol. 112(2) , pp. 475–477 · doi:10.1097/aog.0b013e318179475b · W2034570748
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A 42-year-old woman developed clear cell adenocarcinoma arising in endometriosis at a previous episiotomy site three years after excision and treatment for an endometriotic cyst.

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This case report describes a 42-year-old woman who developed a palpable mass at the site of a previous episiotomy, three years after excision of an endometriotic cyst and subsequent hormonal therapy. Biopsy results confirmed the presence of clear cell adenocarcinoma arising from the residual endometriosis, leading to radical surgical intervention without adjuvant treatment. The patient remained free of recurrence at the ten-month follow-up, highlighting the importance of monitoring for malignant degeneration in cases of recurrent extragonadal endometriosis. This paper is centrally about endometriosis — specifically the rare malignant transformation of endometriosis located in a previous episiotomy scar into clear cell adenocarcinoma.

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Abstract

In Brief BACKGROUND: Malignant transformation of endometriosis in an episiotomy site is rare. CASE: A 42-year-old woman presented with a palpable mass, 2.5 cm in size, just inside the posterior commissure of the vagina, at the site of a previous episiotomy for a vaginal delivery. Three years previously, an endometriotic cyst had been excised at the same site, and the patient had been treated with a gonadotropin-releasing hormone analogue for 6 months. Biopsy revealed a clear cell adenocarcinoma arising in endometriosis. The patient underwent radical surgery alone without adjuvant therapy. At 10-month follow-up, there was no evidence of recurrence. CONCLUSION: Patients who experience a recurrence of extragonadal endometriosis after prior therapy should be monitored carefully for malignant degeneration. A clear cell carcinoma arose in endometriosis of a previous episiotomy site.
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Background

Malignant transformation of endometriosis in an episiotomy site is rare. CASE: A 42-year-old woman presented with a palpable mass, 2.5 cm in size, just inside the posterior commissure of the vagina, at the site of a previous episiotomy for a vaginal delivery. Three years previously, an endometriotic cyst had been excised at the same site, and the patient had been treated with a gonadotropin-releasing hormone analogue for 6 months. Biopsy revealed a clear cell adenocarcinoma arising in endometriosis. The patient underwent radical surgery alone without adjuvant therapy. At 10-month follow-up, there was no evidence of recurrence.

Conclusion

Patients who experience a recurrence of extragonadal endometriosis after prior therapy should be monitored carefully for malignant degeneration.

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endometriosis

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