Exclusive nodal recurrence after treatment of degenerated parietal endometriosis

Nicolas Bourdel, Bourdel N, Maud Durand, Durand M, Pierre Gimbergues, Gimbergues P, J Dauplat, Jacques Dauplat, Dauplat J, Michel Canis
Fertility and sterility · 2010 · vol. 93(6) , pp. 2074.e1–2074.e6 · doi:10.1016/j.fertnstert.2009.11.004 · PMID:20045513 · W2152328627
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This paper investigated nodal recurrence rates in patients treated for parietal endometriosis and found that recurrence primarily occurred in the lymph nodes.

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Abstract

ObjectiveTo report a case of endometriosis degenerated into clear cell carcinoma with positron-emission tomography (PET) scan staging.DesignCase report.SettingUniversity hospital.Patient(s)A 43-year-old woman diagnosed with endometriosis degenerated into clear cell carcinoma with nodal metastasis at the initial diagnosis and exclusive nodal recurrence 6 months after surgery.Intervention(s)Resection of the mass with partial resection of the pubic symphysis and bilateral external iliac lymphadenectomy. Forty-five days later, hysterectomy with bilateral adnexectomy and then adjuvant chemotherapy and abdominal-pelvic radiotherapy.Main outcome measure(s)The PET scan showed positive lymph nodes in the cervical, supraclavicular, bilateral axillary, bilateral inguinal, and lumbar-aortic regions.Result(s)The patient experienced a tumor recurrence after 6 months. After surgical management, she was scheduled to receive six cycles of rescue chemotherapy. She died 22 months after the initial diagnosis.Conclusion(s)The use of PET scan could allow better staging at the initial diagnosis and improve follow-up in such patients. The treatment of this entity is based on radical surgery associated with adjuvant chemotherapy and radiotherapy, but the results are not satisfactory.

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Condition tags

endometriosis

MeSH descriptors

Adenocarcinoma, Clear Cell Endometriosis Peritoneal Diseases Uterine Neoplasms Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adult Endometriosis Endometriosis Endometriosis Female Humans Lymphatic Metastasis Lymph Node Excision Peritoneal Diseases Peritoneal Diseases Peritoneal Diseases Peritoneum Peritoneum

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