Primary Abdominal Wall Clear Cell Carcinoma: Case Report and review of literature

Author(s):  
J J Zhai ◽  
H Y Feng ◽  
R B Ying ◽  
C H Chen

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. Clear cell carcinoma of the endometrium is a very rare and highly malignant neoplasm that accounts for less than 5% of endometrial carcinoma.Case presentation: We report a very rare case of clear cell adenocarcinoma arising from endometriosis of the abdominal scar. We must pay more attention on the following points in the surgical treatment of clear cell carcinoma:(1) Extensively resect tumors as far as possible;(2) Surgical treatment of clear cell carcinoma would easily result in poor wound healing especially in the patients receiving chemotherapy or radiotherapy because of extensive soft tissue stripping .Conclusion: The patient died only 25 months after she was first diagnosed with the cancer.Lessons: This case highlights the difficulties in preoperative diagnosis as well as the poor prognosis of these tumors .Accurate diagnosis of a lump within a scar is important to define the prognosis and treatment. These therapeutic principles are increasingly being applied to patients presenting with tumors greater than 5cm and negative lymph nodes or even smaller tumors, who are considered to have operable disease and a better outcome .Early recognition and prompt treatment can be essential to these patients' survival.

2013 ◽  
Vol 13 (2) ◽  
pp. 79-80
Author(s):  
Zane Simtniece ◽  
Gatis Kirsakmens ◽  
Ilze Strumfa ◽  
Andrejs Vanags ◽  
Maris Pavars ◽  
...  

Abstract Here, we report surgical treatment of a patient presenting with pancreatic metastasis (MTS) of renal clear cell carcinoma (RCC) 11 years after nephrectomy. RCC is one of few cancers that metastasise in pancreas. Jaundice, abdominal pain or gastrointestinal bleeding can develop; however, asymptomatic MTS can be discovered by follow-up after removal of the primary tumour. The patient, 67-year-old female was radiologically diagnosed with a clinically silent mass in the pancreatic body and underwent distal pancreatic resection. The postoperative period was smooth. Four months after the surgery, there were no signs of disease progression.


2021 ◽  
pp. 205141582098766
Author(s):  
Harshit Garg ◽  
Brusabhanu Nayak ◽  
Tripti Nakra ◽  
Prabhjot Singh ◽  
Seema Kaushal

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.


2021 ◽  
Author(s):  
Vishal Bahall ◽  
Lance De Barry ◽  
Arlene Rampersad

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.


2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Kazuhiro Watanabe ◽  
Go Hasegawa ◽  
Yohei Ikeda ◽  
Noboru Hara ◽  
Tsutomu Nishiyama

A 70-year-old woman was referred to our hospital with gross hematuria and diagnosed with right invasive ureteral cancer and bladder urothelial carcinoma in situ. Intravesical BCG therapy and neoadjuvant chemotherapy with carboplatin and gemcitabine were performed at the same time. Subsequently, laparoscopic right nephroureterectomy was performed. Urothelial carcinoma in situ persisted; however, most of the tumor was clear cell carcinoma. The clear cell carcinoma lesion had clear cytoplasm with round nuclei and visible nucleoli in an insular arrangement as is the case with clear cell renal cell carcinoma. No transitional lesion between clear cell adenocarcinoma and urothelial carcinoma was presented. The clear cell carcinoma lesion was GATA3 negative and HNF4α positive; however, the urothelial cancer lesion was GATA3 positive and HNF4α negative. Clear cell carcinoma was diagnosed as clear cell adenocarcinoma similar to clear cell renal cell carcinoma histology.


2020 ◽  
Vol 2020 (4) ◽  
Author(s):  
Anaïs Provendier ◽  
Martina Aida Angeles ◽  
Olivier Meyrignac ◽  
Claire Illac ◽  
Anne Ducassou ◽  
...  

Abstract Malignant transformation of abdominal wall endometriosis lesions developed in a cesarean section scar is a rare event. Patients with uterine adenomyosis but without endometriosis can also develop abdominal wall malignant carcinoma after a gynecologic surgery. The treatment of abdominal wall clear cell adenocarcinoma combines tumor surgical excision with free margins, radiotherapy and chemotherapy. We report a case of clear cell carcinoma arising from an abdominal wall cesarean section scar in a patient without history of endometriosis.


1999 ◽  
Vol 14 (2) ◽  
pp. 217 ◽  
Author(s):  
Suk Won Park ◽  
Se Mie Hong ◽  
Hong Gyun Wu ◽  
Sung Whan Ha

1986 ◽  
Vol 18 (1) ◽  
pp. 37-43
Author(s):  
M. Czaplicki ◽  
A. Borkowski ◽  
S. Wesołowski ◽  
B. Kuzaka ◽  
S. Walecki ◽  
...  

2019 ◽  
Vol 14 (2) ◽  
pp. 65-66
Author(s):  
Shreena Shrestha ◽  
Ganesh Dangal ◽  
Kabin Bhattachan

Clear cell carcinoma of cervix is a rare neoplasm accounting for round 4% of all adenocarcinomas. It is usually seen in patients with a history of intrauterine exposure to diethylstilbestrol. We are reporting a case of clear cell carcinoma of cervix in a 50 years old P1L1 postmenopausal woman, with no history of exposure to diethylstilbestrol in-utero or synthetic non-steroidal estrogen, and who was managed with neoadjuvant chemotherapy followed by modified radical hysterectomy with pelvic lymphadenectomy and adjuvant chemotherapy.


Endocrines ◽  
2021 ◽  
Vol 2 (3) ◽  
pp. 251-265
Author(s):  
Naoki Inoue ◽  
Takashi Hirakawa ◽  
Junji Mitsushita ◽  
Yoshikazu Kitahara ◽  
Akira Iwase

Endometriosis-associated ovarian malignancies have been well documented. Although these malignancies also occur as extraovarian lesions, little is known about them. Thus, this literature review aimed to further explore these rarely experienced tumors. A total of 257 published cases between April 1990 and April 2020 were found using PubMed, and 212 cases were included in the analysis considering Sampson’s criteria and the history of endometriosis. We classified these cases as follows: intestine, abdominal scar, vagina and vulva, peritoneum and deep endometriosis, urinary tract, uterine cervix, and others. Age of patients, history of endometriosis, types of past hormonal therapy, symptoms, histological types, and treatment were identified. The most common tumor site was the intestine. Endometrioid carcinoma was the dominant histological type. Contrary to the ovary, clear cell carcinoma was rare in extraovarian sites. On the other hand, clear cell carcinoma represented the largest number of abdominal scars. This difference may help us to understand the development of endometriosis-related malignancies. Hormonal treatment was mentioned in 67 cases and estrogen replacement therapy in 33 cases. Although risks of estrogen therapy are still controversial, the highly differentiated histological types and hormone-dependent characteristics of endometriosis-associated malignancy should be considered. Physicians should be careful about estrogen monotherapy after hysterectomy and long-term hormone replacement therapy in patients with a history of endometriosis.


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