Incisional carcinoma of Mullerian Origin: A case report and review of literature
Open accessAbstract
Primary incisional carcinoma (PIC) is a rare, delayed complication of surgery, usually attributed to the malignant transformation of endometriosis. We report a case of incisional carcinoma with nodal metastases in a 55-year-old woman, 18 years after cesarean section. She underwent extirpative surgery, including hysterectomy and bilateral salpingo-oophorectomy, without intraperitoneal disease identifed. Adjuvant treatment included sandwiched platinum-based chemotherapy (carboplatin and paclitaxel) and radiation. She remains disease-free 8 months after completing therapy. We identified 46 additional reported cases. Of these, >90% had undergone an "endometrium-exposing" surgery, most commonly cesarean section; while no cases followed adnexal-only surgery. The median time between antecedent surgery and presentation was 18 years. At presentation, tumors were often large (median 8 cm), and symptomatic with pain (63%) and/or mass (26%). Serum CA125 levels were commonly, albeit slightly, elevated (median 57U/ml (IQR 22-96, Range 6-1690)). Lymph node metastases were common (35%), with most following a vulvar-type spread pattern (inguinal first). Most patients (63%) were treated with chemotherapy +/- radiation. Approximately 50% of patients recurred promptly (median < 6 months), but long-term survival was reported following combined chemotherapy/radiation. Lymph node metastases portended a shorter disease-free interval, with 73% of cases recurring (median 5 months) despite chemotherapy-based treatment. These data suggest that some incisional carcinomas may result from displacement of healthy endometrium followed by delayed malignant transformation. Chemotherapy-only and radiation-only treatments are attended by modest prognosis. Taken together, these data suggest there is both need and potential avenues for improved prevention, detection, and treatment of this condition.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
90% of malignant scar endometriosis have undergone previous gynecological procedures with endometrium exposure, including cesarean sections.
“It must be emphasized that 90% of malignant scar endometriosis have undergone previous gynecological procedures with endometrium exposure, including and not limited to cesarean sections, therefore making the translocation theory more plausible [31].”
From Malignancy in Abdominal Wall Endometriosis: Is There a Way to Avoid It? A Systematic Review (2024) · cites this paper as [31]
The Discussion > Origin (page unavailable) reports that over 90% of patients with primary incisional carcinoma had undergone procedures with possible endometrial exposure, including cesarean section, and presents this as support for translocation. The claim narrows that group to malignant scar endometriosis, but the paper says primary incisional carcinoma can occur without associated endometriosis. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe translocation theory holds that benign endometriosis is iatrogenically transported to the surgical scar where it transforms into neoplasia.
“The second theory is the “translocation theory”. According to this theory, benign endometriosis is iatrogenically transported to the surgical scar where it transforms into neoplasia.”
From Malignancy in Abdominal Wall Endometriosis: Is There a Way to Avoid It? A Systematic Review (2024) · cites this paper as [31]
The Discussion > Origin passage describes surgical translocation of benign endometrial gland cells followed by malignant transformation. It distinguishes that mechanism from malignant transformation of established endometriosis; the claim conflates them by saying benign endometriosis itself is transported. Page numbers are not provided in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe translocation theory is more plausible than the primary incisional carcinoma theory.
“It must be emphasized that 90% of malignant scar endometriosis have undergone previous gynecological procedures with endometrium exposure, including and not limited to cesarean sections, therefore making the translocation theory more plausible [31].”
From Malignancy in Abdominal Wall Endometriosis: Is There a Way to Avoid It? A Systematic Review (2024) · cites this paper as [31]
The Discussion > Origin reports that over 90% of patients with primary incisional carcinoma had undergone procedures with possible endometrial exposure and presents this as evidence for translocation. It does not establish that translocation is more plausible than another mechanism overall; it describes primary incisional carcinoma as the condition to be explained, not a competing theory. The cited figure also concerns patients with primary incisional carcinoma, rather than specifically malignant scar endometriosis. (LLM, conf=0.86)
Experimental — accuracy not yet measuredHalf of the 11 patients with lymphatic metastases and available follow-up, who received adjuvant chemotherapy, died of the disease within a median of 11.5 months.
“Half of the 11 patients with lymphatic metastases and available follow-up, who received adjuvant chemotherapy, died of the disease within a median of 11.5 months [31].”
From Malignancy in Abdominal Wall Endometriosis: Is There a Way to Avoid It? A Systematic Review (2024) · cites this paper as [31]
The Discussion’s “Adjuvant treatment and prognosis” section reports follow-up for 11 patients with lymph-node metastases, all referred for adjuvant chemotherapy. Four of the eight who recurred—not half of all 11—died of disease at a median of 11.5 months. (LLM, conf=0.93)
Experimental — accuracy not yet measuredThis long interval is in favor of the translocation theory of benign endometriosis.
“This long interval is in favor of the translocation theory of benign endometriosis [31].”
From Malignancy in Abdominal Wall Endometriosis: Is There a Way to Avoid It? A Systematic Review (2024) · cites this paper as [31]
The primary incisional carcinoma theory holds that established benign abdominal wall endometriosis transforms into a malignant tumor.
“The first theory is the “primary incisional carcinoma”. This theory presents established benign abdominal wall endometriosis transforming into a malignant tumor.”
From Malignancy in Abdominal Wall Endometriosis: Is There a Way to Avoid It? A Systematic Review (2024) · cites this paper as [31]
Most patients with primary incisional carcinoma had a surgical history (89% cesarean section and 4% myomectomies).
“Most of the patients with primary incisional carcinoma had a surgical history (89% cesarean section and 4% myomectomies) [31].”
From Malignancy in Abdominal Wall Endometriosis: Is There a Way to Avoid It? A Systematic Review (2024) · cites this paper as [31]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 52 · Cited by 10
- Authors
- Bedell, S., Chang, Z., Burt, C., Khalifa, M. A., & Argenta, P. A.
- Affiliations
- University of Minnesota (US)
- Corresponding author
- Argenta, Peter A.
- Venue
- Gynecologic Oncology Reports
- Publisher
- Elsevier BV
- Published
- 2020-08
- Volume
- 33
- Pages
- 100588
- ISSN
- 2352-5789 (ISSN-L)
- PMC
- PMC7262414
- OpenAlex
- W3026548657
- Cited by
- 10
- References
- 52
- Citations by year
- 2025: 1 · 2024: 2 · 2022: 2 · 2021: 4 · 2020: 1
- FWCI
- 1.07
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Gynecologic Oncology Reports (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
- Health Sciences › Medicine › Reproductive Medicine › Ovarian cancer diagnosis and treatment
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Keywords
- endometriosis-associated cancer, cesarean section, hysterectomy, bilateral salpingo-oophorectomy, lymph node metastasis, carboplatin, paclitaxel, adjuvant chemotherapy, radiotherapy, CA125, recurrence, long-term survival
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
