Primary peritoneal clear cell adenocarcinoma arising in previous abdominal scar for endometriosis surgery

Koji Matsuo, Alonsozana EL, Edgar L. C. Alonsozana, Eno ML, Michele L. Eno, Rosenshein NB, Neil B. Rosenshein, Dwight D. Im, Im DD
Archives of gynecology and obstetrics · 2009 · vol. 280(4) , pp. 637–641 · doi:10.1007/s00404-009-0962-y · PMID:19219617 · W2107881658
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⚙ AI-generated summary by gemini-2.5-flash-lite+body, 2026-06-14 ⓘ

This case report describes a primary peritoneal clear cell adenocarcinoma arising from an abdominal scar in a patient previously operated on for endometriosis.

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This paper reports a single case of a 37-year-old woman who developed a large heterogeneous cystic mass in the mons pubis 10 years after laparotomy for endometrioma/endometriosis. MRI and initial cytoreductive surgery found no peritoneal tumor, and definitive excision was technically limited by severe adhesions until after six cycles of taxotere and carboplatin, after which secondary cytoreductive surgery achieved optimal macroscopic resection. The tumor was diagnosed as primary peritoneal clear cell adenocarcinoma arising from a prior abdominal scar, supported by immunohistochemical staining (CK7 positive, EMA and Ber-Ep4 positive, others negative as reported). The main limitation is that the evidence is a single case report. This paper is centrally about endometriosis — it describes primary peritoneal clear cell adenocarcinoma arising in a previous abdominal scar associated with prior endometriosis surgery.

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Abstract

BackgroundEndometriosis-associated ovarian cancer arising from the surgical incision site is an unusual clinical entity.CaseA 37-year-old woman presented with a chief complaint of progressive swelling of the mons pubis. The patient was status post laparotomy for endometrioma/endometriosis 10 years ago. MRI showed a heterogeneous multiseptated large cystic mass within the mons pubis measuring 14 x 13.4 x 10.6 cm. Initial cytoreductive surgery revealed no evidence of tumor in the peritoneal cavity. The surgery was suboptimal due to severe adhesions to the symphysis pubis. The secondary cytoreductive surgery performed after six cycles of taxotere and carboplatin was optimal. Macroscopically, the tumor was a dusky pink-purple and contained a dense white-gray to light yellow gelatinous area. The tumor was a malignant cystic and glandular neoplasm. Immunohistochemical stains included CK7(+), CK5/6(-), EMA(+), Ber-Ep4(+), Calretinin(-), ER(-), and PR(-).ConclusionPrimary peritoneal clear cell adenocarcinoma arising from an abdominal scar associated with prior endometrioma/endometriosis surgery was first reported.
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Abstract

Background Endometriosis-associated ovarian cancer arising from the surgical incision site is an unusual clinical entity. Case A 37-year-old woman presented with a chief complaint of progressive swelling of the mons pubis. The patient was status post laparotomy for endometrioma/endometriosis 10 years ago. MRI showed a heterogeneous multiseptated large cystic mass within the mons pubis measuring 14 × 13.4 × 10.6 cm. Initial cytoreductive surgery revealed no evidence of tumor in the peritoneal cavity. The surgery was suboptimal due to severe adhesions to the symphysis pubis. The secondary cytoreductive surgery performed after six cycles of taxotere and carboplatin was optimal. Macroscopically, the tumor was a dusky pink-purple and contained a dense white-gray to light yellow gelatinous area. The tumor was a malignant cystic and glandular neoplasm. Immunohistochemical stains included CK7(+), CK5/6(−), EMA(+), Ber-Ep4(+), Calretinin(−), ER(−), and PR(−).

Conclusion

Primary peritoneal clear cell adenocarcinoma arising from an abdominal scar associated with prior endometrioma/endometriosis surgery was first reported.

References

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Condition tags

endometriosis

MeSH descriptors

Adenocarcinoma, Clear Cell Cicatrix Endometriosis Peritoneal Neoplasms Postoperative Complications Adenocarcinoma, Clear Cell Adult Cicatrix Endometriosis Endometriosis Female Humans Peritoneal Neoplasms Postoperative Complications

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