Clear Cell Adenocarcinoma Arising from Endometriosis in Abdominal Wall Cesarean Section Scar: A Case Report and Literature Review

Liu D, Wei H, Huang J, Shen H, Wang X, Hu C
2023 · W7036621105
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This case report describes a clear cell carcinoma arising from abdominal wall endometriosis in a cesarean section scar and reviews prior literature on this rare condition.

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This case report and literature review describes a 48-year-old woman with an enlarging, painful abdominal wall mass at a prior cesarean section scar, assessed with physical exam, CT, and MRI, followed by histological evaluation. Imaging identified a large, multi-septated cystic lesion, and pathology found clear cell adenocarcinoma arising from abdominal wall endometriosis tissue. The authors emphasize that scar endometriosis malignant transformation is extremely rare and note the inherent limitation of case-based evidence and reliance on available prior reports. This paper is centrally about endometriosis—specifically malignant transformation of abdominal wall endometriosis in a cesarean section scar into clear cell adenocarcinoma.

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Abstract

Dong Liu,1,* Huanhuan Wei,2,* Jinyu Huang,1 Hailin Shen,3 Ximing Wang,1 Chunhong Hu1 1Radiological Department, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China; 2Academy of Medical Sciences, the People’s Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; 3Department of Radiology, Suzhou Kowloon Hospital, Shanghai Jiaotong University School of Medicine, Suzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chunhong Hu, Email [email protected]: Endometriosis developing in a cesarean section (CS) scar is an unusual event. Malignant transformation arising on the background of scar endometriosis in the abdominal wall is extremely rare. Herein we report a case of clear cell carcinoma (CCC) arising in the abdominal wall from endometriosis tissues following CS and review previous literature.Case Presentation: A 48-year-old gravida 2 para 1 female presented with an abdominal wall mass at her CS scar, which increased in size and became painful in the last 2 years. Physical examination showed a multilocular solid mass of about 13 cm, at the previous CS scar. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a 12.8cm × 7.7cm multi-septate cystic lesion on the anterior abdominal wall, and histological examination showed that CCC was caused by the transformation of abdominal wall endometriosis (AWE).Conclusion: An endometriosis-associated malignancy should be considered in the differential with any enlarging mass in the abdominal wall scar.Keywords: cesarean section, abdominal wall endometriosis, case report
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International Journal of Women's Health (Jan 2023) Clear Cell Adenocarcinoma Arising from Endometriosis in Abdominal Wall Cesarean Section Scar: A Case Report and Literature Review Abstract Dong Liu,1,* Huanhuan Wei,2,* Jinyu Huang,1 Hailin Shen,3 Ximing Wang,1 Chunhong Hu1 1Radiological Department, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China; 2Academy of Medical Sciences, the People’s Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; 3Department of Radiology, Suzhou Kowloon Hospital, Shanghai Jiaotong University School of Medicine, Suzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chunhong Hu, Email [email protected]: Endometriosis developing in a cesarean section (CS) scar is an unusual event. Malignant transformation arising on the background of scar endometriosis in the abdominal wall is extremely rare. Herein we report a case of clear cell carcinoma (CCC) arising in the abdominal wall from endometriosis tissues following CS and review previous literature.Case Presentation: A 48-year-old gravida 2 para 1 female presented with an abdominal wall mass at her CS scar, which increased in size and became painful in the last 2 years. Physical examination showed a multilocular solid mass of about 13 cm, at the previous CS scar. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a 12.8cm × 7.7cm multi-septate cystic lesion on the anterior abdominal wall, and histological examination showed that CCC was caused by the transformation of abdominal wall endometriosis (AWE).Conclusion: An endometriosis-associated malignancy should be considered in the differential with any enlarging mass in the abdominal wall scar.Keywords: cesarean section, abdominal wall endometriosis, case report

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