Primary abdominal wall clear cell carcinoma arising in a Caesarean section scar endometriosis

Alberto VO; V O Alberto; Lynch M; M Lynch; Labbei FN; F N Labbei; Jeffers M; M Jeffers

doi:10.1007/BF03169006

Primary abdominal wall clear cell carcinoma arising in a Caesarean section scar endometriosis

Alberto VO, V O Alberto, Lynch M, M Lynch, Labbei FN, F N Labbei, Jeffers M, M Jeffers

Irish journal of medical science · 2006 · doi:10.1007/BF03169006 · PMID:16615235

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This case report and literature review describes a rare instance of primary abdominal wall clear cell carcinoma arising in endometriosis of a Caesarean section scar.

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This case report describes a patient with a history of pelvic endometriosis who presented with a large right lower quadrant abdominal wall mass located within a Caesarean section scar, and histology showed primary clear cell carcinoma arising in scar endometriosis; the authors also review related literature. They note that, although scar endometriosis is recognized and malignant transformation can occur, clear cell carcinoma is unusual, and this report is described as the first reported primary abdominal wall clear cell carcinoma developing within a Caesarean section scar in Ireland per the Irish National Cancer Registry. A limitation explicitly acknowledged by the paper format is that it is a single-patient report supported by a narrative literature review rather than original case-control data. This paper is centrally about endometriosis — it documents malignant transformation of Caesarean section scar endometriosis into primary abdominal wall clear cell carcinoma.

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Abstract

BACKGROUND: Endometriosis occurring in a surgical scar is well recognized and occurs mainly in patients with a history of hysterectomy or Caesarean section. Scar endometriosis, as well as endometriosis at other sites, can undergo malignant change. Endometrioid carcinoma is the most common malignant tumour arising in endometriosis. However, clear cell carcinoma can also occur but is unusual. AIM: To discuss the diagnosis and management of such a case. METHODS: We report a case of primary clear cell carcinoma in endometriosis of a Caesarean section scar and review the literature. RESULTS: The patient presented with a large right lower quadrant abdominal wall mass within a Caesarean section scar. Histological examination revealed a clear cell carcinoma. The patient had a prior history of pelvic endometriosis. According to the Irish National Cancer Registry, this is the first reported case of a primary abdominal wall clear cell carcinoma developing within a Caesarean section scar in Ireland. CONCLUSION: Any lesion occurring in a Caesarean section scar with a history of previous endometriosis cannot be underestimated and warrants careful clinical follow-up and histological evaluation as appropriate.

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Abstract

Background Endometriosis occurring in a surgical scar is well recognized and occurs mainly in patients with a history of hysterectomy or Caesarean section. Scar endometriosis, as well as endometriosis at other sites, can undergo malignant change. Endometrioid carcinoma is the most common malignant tumour arising in endometriosis. However, clear cell carcinoma can also occur but is unusual. Aim To discuss the diagnosis and management of such a case.

Methods

We report a case of primary clear cell carcinoma in endometriosis of a Caesarean section scar and review the literature.

Results

The patient presented with a large right lower quadrant abdominal wall mass within a Caesarean section scar. Histological examination revealed a clear cell carcinoma. The patient had a prior history of pelvic endometriosis. According to the Irish National Cancer Registry, this is the first reported case of a primary abdominal wall clear cell carcinoma developing within a Caesarean section scar in Ireland.

Conclusion

Any lesion occurring in a Caesarean section scar with a history of previous endometriosis cannot be underestimated and warrants careful clinical follow-up and histological evaluation as appropriate. Similar content being viewed by others

References

Honore GM. Extrapelvic endometriosis.Clin Obstet Gynecol 1999; 42: 699–711 Phupong V, Triratanachat S. Caesarean section scar endometriosis: a case report and review of literature.J Med Assoc Thai (Thailand) 2002;85: 733–8 Robert CS, Rajesh D, Rex CB. Malignancy in Endometriosis: Frequency and comparison of ovarian and extra ovarian types.Int J Gynecol Pathol 2001; 20: 133–139 Sampson JA. Endometrial carcinoma of ovary arising in endometrial tissue in that organ.Arch Surg 1925; 10: 1–12 Koger KE, Shatney CH, Hodge K. Surgical scar endometrioma.Surg Gynecol Obstet 1993; 177: 243–6. Gucer F, Pieber D, Arikan MG. Malignancy arising in extraovarian endometriosis during estrogen stimulation.Eur J Gynecol Oncol 1998; 19: 39–41 Brunson GL, Barclay, Sanders M, Araoz CA. Malignant extra ovarian Endometriosis Two case reports and review of the literature.Gynecol Oncol 1988;30: 123–30 Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Alberto, V.O., Lynch, M., Labbei, F.N. et al. Primary abdominal wall clear cell carcinoma arising in a Caesarean section scar endometriosis. Ir J Med Sci 175, 69–71 (2006). https://doi.org/10.1007/BF03169006 Issue date: DOI: https://doi.org/10.1007/BF03169006

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Condition tags

endometriosis

MeSH descriptors

Adenocarcinoma, Clear Cell Carcinoma, Endometrioid Cesarean Section Cicatrix Endometriosis Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adult Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Cesarean Section Cicatrix Endometriosis Female Humans

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