Endometriosis-Associated Malignant Transformation Arising in a Laparotomy Scar: A Case Report and Literature Review

Tsotne Dadiani, Niko Koridze, Mariam Morchadze, Alexandra Barnovi, Keti Kebadze, Melita Modebadze, Mariam Dvaladze, Ketevani Azikuri, Sofiko Goshadze
2025 · doi:10.5281/zenodo.16267907 · W6912053402
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This paper is a case report with a literature review describing endometriosis-associated malignant transformation occurring in a laparotomy scar, presenting as an endometrioid adenocarcinoma arising from scar endometriosis, a very rare extraovarian site. It outlines that such diagnoses require comprehensive histopathology and immunohistochemical analysis and notes that symptoms are often nonspecific and can mimic benign postoperative complications or soft-tissue tumors, contributing to diagnostic delays. As a case report plus review, its primary limitation is that evidence is based on a single detailed case and aggregation of previously published reports rather than systematic, generalizable study results. This paper is centrally about endometriosis — it focuses on malignant transformation of endometriosis in a laparotomy scar with an endometrioid adenocarcinoma diagnosis.

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Abstract

Endometriosis is a common estrogen-dependent condition, affecting approximately 10% of women of reproductive age. It is characterized by the presence of endometrial-like tissue outside the uterine cavity. While malignant transformation of endometriosis typically occurs in ovarian tissue, such transformation at extraovarian sites—particularly within abdominal wall scars—is exceedingly rare. Fewer than 50 cases of malignancies arising from abdominal wall scar endometriosis have been reported globally. The most commonly observed histological types include clear cell carcinoma and endometrioid adenocarcinoma. Diagnosis requires comprehensive histopathological and immunohistochemical analysis. Patients with such transformations often present with nonspecific symptoms, which can mimic benign postoperative complications or soft tissue tumors, thereby contributing to diagnostic delays. Given the aggressive behavior and potential for recurrence, early recognition and intervention are crucial. This report describes a rare case of endometrioid adenocarcinoma arising from endometriosis in a laparotomy scar, underscoring the importance of timely diagnosis and a multidisciplinary approach to optimize clinical outcomes.
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Endometriosis-Associated Malignant Transformation Arising in a Laparotomy Scar: A Case Report and Literature Review Description Endometriosis is a common estrogen-dependent condition, affecting approximately 10% of women of reproductive age. It is characterized by the presence of endometrial-like tissue outside the uterine cavity. While malignant transformation of endometriosis typically occurs in ovarian tissue, such transformation at extraovarian sites—particularly within abdominal wall scars—is exceedingly rare. Fewer than 50 cases of malignancies arising from abdominal wall scar endometriosis have been reported globally. The most commonly observed histological types include clear cell carcinoma and endometrioid adenocarcinoma. Diagnosis requires comprehensive histopathological and immunohistochemical analysis. Patients with such transformations often present with nonspecific symptoms, which can mimic benign postoperative complications or soft tissue tumors, thereby contributing to diagnostic delays. Given the aggressive behavior and potential for recurrence, early recognition and intervention are crucial. This report describes a rare case of endometrioid adenocarcinoma arising from endometriosis in a laparotomy scar, underscoring the importance of timely diagnosis and a multidisciplinary approach to optimize clinical outcomes. Files 130-Review paper-Tsotne Dadiani.pdf Files (4.2 MB) | Name | Size | Download all | |---|---|---| | md5:cff2f558c4f4c3de8879bbbbb3daab11 | 4.2 MB | Preview Download |

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