Clear Cell Carcinoma Arising from Abdominal Wall Endometriosis – A Report on Two Cases and Literature Review

Abstract Background: Malignant transformation of abdominal wall endometriosis is extremely rare. Clear cell carcinoma and endometrioid carcinoma are the two most prevalent histological subtypes of malignant endometriosis. To date, approximately thirty cases of clear cell carcinoma arising from abdominal wall endometriosis have been described worldwide.Case Presentation: We report two cases of clear cell carcinoma developing postoperatively in the anterior abdominal wall in women with a history of extensive endometriosis. Histopathology of the resected abdominal wall tumor demonstrated benign endometriosis contiguous with features of clear cell carcinoma. These histological features satisfied Sampson’s criteria which are required for diagnosing malignant endometriosis. Both patients were successfully managed with platinum-based adjuvant chemotherapy following cytoreductive surgery. Conclusion: Clear cell carcinoma arising from abdominal wall endometriosis is a rare, highly aggressive cancer with a propensity to recur or metastasize. Due to the limited publications on this clinical entity, there are no clearly established protocols regarding adjuvant treatment, and an evaluation of prognostic factors is lacking. Clinicians must have a high index of suspicion for malignant endometriosis of the abdominal wall, particularly in patients with an abdominal wall mass, prior abdominal surgery, and long-standing endometriosis. By presenting our case, we expect to raise awareness and study of this rare endometriosis-related neoplasm.

Download Full-text

Clear cell carcinoma arising from abdominal wall endometriosis: a unique case with bladder and lymph node metastasis

World Journal of Surgical Oncology ◽

10.1186/1477-7819-12-51 ◽

2014 ◽

Vol 12 (1) ◽

pp. 51 ◽

Cited By ~ 14

Author(s):

Haiyuan Liu ◽

Jinghua Leng ◽

Jinghe Lang ◽

Quancai Cui

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Cell Carcinoma ◽

Abdominal Wall ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Unique Case ◽

Abdominal Wall Endometriosis ◽

Node Metastasis

Download Full-text

Malignant transformation of abdominal wall endometriosis to clear cell carcinoma: case report

Sao Paulo Medical Journal ◽

10.1590/1516-3180.2017.0103300417 ◽

2018 ◽

Vol 136 (6) ◽

pp. 586-590 ◽

Cited By ~ 3

Author(s):

João Kleber de Almeida Gentile ◽

Renato Migliore ◽

Fábio Jorge Neubaner Kistenmacker ◽

Marcio Menezes de Oliveira ◽

Rodrigo Biscuola Garcia ◽

...

Keyword(s):

Case Report ◽

Cell Carcinoma ◽

Abdominal Wall ◽

Malignant Transformation ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Abdominal Wall Endometriosis

Download Full-text

Malignant transformation of abdominal wall endometriosis to clear cell carcinoma: case report and review of the literature

Fertility and Sterility ◽

10.1016/j.fertnstert.2007.08.080 ◽

2008 ◽

Vol 90 (4) ◽

pp. 1197.e13-1197.e16 ◽

Cited By ~ 34

Author(s):

Anne Sophie Bats ◽

Yaelle Zafrani ◽

Patricia Pautier ◽

Pierre Duvillard ◽

Philippe Morice

Keyword(s):

Case Report ◽

Cell Carcinoma ◽

Abdominal Wall ◽

Malignant Transformation ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Review Of The Literature ◽

Abdominal Wall Endometriosis

Download Full-text

Is clear cell carcinoma of abdominal wall surgery scar associated with endometriosis a poor prognosis? A case report and literature review

10.21203/rs.3.rs-146993/v1 ◽

2021 ◽

Author(s):

Xuzhi Liang ◽

Hao Zeng ◽

Zhe Tang ◽

Jiejie Liao ◽

Jiangtao Fan

Keyword(s):

Case Report ◽

Caesarean Section ◽

Literature Review ◽

Cell Carcinoma ◽

Abdominal Wall ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Specific Marker ◽

Tumor Biopsy ◽

Wall Mass

Abstract BackgroundClear cell carcinoma of abdominal wall surgery scar is a rare condition that can have many potential causes, and its early diagnosis is difficult after undergoing obstetrical and gynecological surgery unless performing tumor biopsy. So far, about 45 cases have been reported in the literature. This paper provides a case report and literature review of clear cell carcinoma on abdominal wall surgical scar.Case presentationWe described the case of a 47-year-old woman reporting two lumps in the scar of abdomen. Her medical history was marked by a previous Caesarean section and two excisions of benign endometriosis nodules at the scar. Physical examination found a mass of about 6×5×5 cm on the left side of the scar with mucoid on the surface and a fixed abdominal wall mass of about 10×10×8 cm in the 2 transverse fingers under the umbilicus. Histological examination proved a clear cell carcinoma result. The patient received tumor excision and first-line chemotherapy with complete remission. A review of the literature showed that 91.3% of the cases had had a Caesarean section. Besides, approximately 34.2% of women died 5–48 months after diagnosis. The average age of women was 46.5 years and the average tumor size was 10 cm.ConclusionThe abdominal wall mass of middle-aged women is closely related to the scar left by the previous Cesarean section and must be investigated in time and properly. Preoperative diagnosis is difficult and often incorrect, and there is no specific marker for malignant transformation. Treatment usually includes surgery, chemotherapy, and radiotherapy, but the prognosis is poor.

Download Full-text

Clear cell carcinoma arising from abdominal wall endometriosis – Brief report and review of the literature

Gynecologic Oncology Reports ◽

10.1016/j.gore.2017.03.008 ◽

2017 ◽

Vol 20 ◽

pp. 78-80 ◽

Cited By ~ 5

Author(s):

Cecília Marques ◽

Teresa S. Silva ◽

Margarida F. Dias

Keyword(s):

Cell Carcinoma ◽

Abdominal Wall ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Review Of The Literature ◽

Abdominal Wall Endometriosis

Download Full-text

Transformation of Abdominal Wall Endometriosis to Clear Cell Carcinoma

Case Reports in Obstetrics and Gynecology ◽

10.1155/2015/123740 ◽

2015 ◽

Vol 2015 ◽

pp. 1-3 ◽

Cited By ~ 4

Author(s):

Maria Paula Ruiz ◽

Darryl Lewis Wallace ◽

Matthew Thomas Connell

Keyword(s):

Radiation Therapy ◽

Cell Carcinoma ◽

Abdominal Wall ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Abdominal Wall Endometriosis ◽

First Case ◽

Wall Lesion

Clear cell carcinoma is the least common of the malignant transformations reported in nonpelvic sites of endometriosis. Two cases with clear cell carcinoma transformation arising from endometriosis in abdominal wall scars are presented. These patients underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, pelvic washings, and abdominal wall lesion resection. The first case had initial treatment with chemotherapy, while chemotherapy and radiation therapy were given for the second case. A recurrence was noted for the chemotherapy only case for, which she was subsequently given radiation, with further resolution of the lesion.

Download Full-text

Clear-cell carcinoma originating from cesarean section scar: two case reports

Journal of Medical Case Reports ◽

10.1186/s13256-021-02775-9 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Seyedeh Razieh Hashemi ◽

Mahdi Morshedi ◽

Houshyar Maghsoudi ◽

Arezoo Esmaeilzadeh ◽

Ibrahim Alkatout

Keyword(s):

Cesarean Section ◽

Cell Carcinoma ◽

Abdominal Wall ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Case Reports ◽

Pubic Symphysis ◽

Tumor Spread ◽

Complete Surgical Excision ◽

Wall Mass

Abstract Background Clear-cell carcinoma arising from the surgical cesarean section scar is very infrequent. The present study reports two patients with clear-cell carcinoma arising from an abdominal wall scar 20 and 23 years after their last cesarean section. Case presentation Both Iranian patients had prior cesarean sections nearly 20 years earlier. Patients 1 and 2 had transverse and vertical abdominal incisions, respectively. The initial clinical presentation was a huge lower abdominal mass at the site of the previous cesarean section scar. Both patients underwent abdominal wall mass biopsy. The histological analysis revealed the presence of malignancy. Both patients underwent full-thickness resection of the abdominal wall mass. All surgical margins were tumor-free; however, patient 1 had a very narrow tumor-free margin near the pubic symphysis. As the imaging report of patient 2 revealed the presence of a pelvic mass, the exploration of the intraperitoneal space, simple total abdominal hysterectomy (TAH), bilateral salpingo-oophorectomy (BSO), and the excision of enlarged pelvic lymph nodes were performed during the surgery. Six cycles of paclitaxel and carboplatin every 3 weeks as adjuvant chemotherapy was administered for both patients after the surgery. One of the patients had disease recurrence 5 months after the termination of chemotherapy, and the other is still disease-free. These two patients had similar pathology and received a similar initial adjuvant treatment; however, they were different in terms of the direction of tumor spread, tumor distance from the pubic symphysis, status of tumor margins, and surgical procedures. Conclusions We encountered distinct prognoses in the clear-cell carcinoma of cesarean section scars presented herein. The researchers can recommend complete surgical excision of the abdominal wall mass with wide tumor-free margins, exploration of the abdominopelvic space, TAH, and BSO during the first surgery.

Download Full-text

Clear cell carcinoma of Mullerian origin in the urinary bladder: A rare entity

Journal of Clinical Urology ◽

10.1177/2051415820987668 ◽

2021 ◽

pp. 205141582098766

Author(s):

Harshit Garg ◽

Brusabhanu Nayak ◽

Tripti Nakra ◽

Prabhjot Singh ◽

Seema Kaushal

Keyword(s):

Urinary Bladder ◽

Cell Carcinoma ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Rare Entity ◽

Level Of Evidence ◽

History Of ◽

Carcinoma Of The Bladder

Mullerian neoplasms of the urinary system are rare but complex tumor-like lesions. The identification of the Mullerian neoplasm is crucial for patient management owing to its etiology, natural history, and prognosis. We present a case of a 42-year-old female with a history of three lower segment cesarean sections presenting with complaints of dysmenorrhea and suprapubic pain with no history of hematuria or any urinary symptoms. Magnetic resonance imaging revealed a 2 cm×2 cm exophytic lesion suspicious of being either a bladder lesion or an endometrial lesion infiltrating the urinary bladder. Cystoscopy and transurethral biopsy of this suspicious bladder tumor revealed a malignant tumor with papillary and tubulocystic architecture. Based on the overall histomorphological and immunohistochemical features, a diagnosis of clear cell carcinoma of Mullerian origin was made, and the patient underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy and partial cystectomy. The patient was kept on regular surveillance and showed no signs of recurrence at the one-year follow-up. Clear cell carcinoma of the bladder of Mullerian origin is a rare entity and is established on histopathology. Prompt diagnosis and a multidisciplinary approach are indispensable for management. Level of evidence: Level 4.

Download Full-text