Malignant transformation of endometriosis in a laparoscopic trocar site a case report

Ling Han, Bingyi Zhang
BMC women's health · 2022 · vol. 22(1) , pp. 163 · doi:10.1186/s12905-022-01749-3 · PMID:35562703 · PMC9103296 · W4280539449
article OA: gold CC0 ⤵ 3 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This case report describes a 54-year-old woman who developed poorly differentiated endometrioid carcinoma at a laparoscopic trocar site, treated with surgery and chemotherapy.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This case report describes a 54-year-old woman who developed a new subcutaneous mass at a laparoscopic trocar site scar 2 years after laparoscopic ovarian endometrioma surgery, with imaging showing a cystic tumor in the subcutaneous fat and elevated CA-199 despite normal tumor markers overall. Pathology demonstrated malignant transformation with poorly differentiated endometrioid carcinoma mixed with clear cell carcinoma, supported by immunohistochemistry and history of prior laparoscopic surgery; staging workup also identified lymph node metastases and suspected peritoneal involvement. The patient underwent surgical staging/complete excision and received six cycles of liposomal doxorubicin plus carboplatin, with CT and follow-up PET-CT showing no recurrence and tumor markers returning to normal, while the authors note the rarity and difficulty of early diagnosis as a key caveat. This paper is centrally about endometriosis — it documents malignant transformation of trocar site abdominal endometriosis into carcinoma following laparoscopic surgery.

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Abstract

BACKGROUND: Malignant transformation of endometriosis is infrequent at the laparoscopic trocar site. Although malignant transformation is uncommon, it must be acknowledged in order to achieve radical resection. CASE PRESENTATION: We report on a 54-year-old woman with trocar site endometriosis 2 years after laparoscopic ovarian endometrial resection. Physical examination revealed a subcutaneous solid tumor with a diameter of 3 cm surrounding the scar of laparoscopic surgery in the right lower abdomen. Transabdominal ultrasonography showed a cystic tumor in the subcutaneous adipose layer of the right lower abdomen. The pathological diagnosis was poorly differentiated endometrioid carcinoma. Hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy were then performed. Histological examination revealed mixed endometrioid carcinoma and clear cell carcinoma. After six cycles of chemotherapy, computed tomography showed no signs of recurrence. CONCLUSIONS: Malignant transformation of laparoscopic endometriosis is very uncommon, and the diagnosis and stage are determined by clinical manifestations and imaging examination. The main therapy methods are radical surgery combined with neoadjuvant chemotherapy and adjuvant radiotherapy. At the same time, reducing iatrogenic abdominal incision implantation is an effective prevention method.

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Condition tags

endometriosis

MeSH descriptors

Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Laparoscopy Laparoscopy Laparoscopy Laparoscopy Laparoscopy Laparoscopy

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References (55)

Cited by (3)

SciLite annotations

organisms 4
microbiota human human murine osteosarcoma virus
chemicals 15
estrogen estrogen heme iron iron heme heme oxygen oxygen positron doxorubicin carboplatin carbohydrate positron ribonucleic acid

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