Clear cell degeneration associated with endometriosis of abdominal wall after cesarean section: A case report and systematic review of literature
Abstract
Aim: The scar of cesarean section (CS) is the most common site of abdominal wall endometriosis (AWE), whose tumor degeneration has been reported in an increasing number of cases; the most frequent histological type is clear cell carcinoma (CCC). Methods: We conducted a systematic research of the literature, collecting data regarding the evidence on tumor degeneration from AWE after CS. Moreover, we reported a case of clear cell borderline tumor (CCBT) originating from AWE. Results: We included data of 37 patients with diagnosis of CCC. The average time between the last CS and the diagnosis of CCC was around 15 years. Overall, 26.0% and 73.9% patients received exclusive local abdominal resection of the lesion and additional surgery, respectively. Lymph nodes involvement was detected in 26.0 % patients and adjuvant chemotherapy was administered in 52.0 % cases. During follow‐up period, 15.2% patients died of disease, 32.6% had no evidence of disease, and 17.4% recurred. We diagnosed a CCBT arose in a patients with AWE and a personal history of several surgical procedures for endometriosis, a CS and a subsequent transverse laparotomy. We performed an open bilateral ovariectomy and a large excision of the endometriotic abdominal lesion. Conclusion: Tumor degeneration from AWE seems to be a real occurrence with an increasing number of events. Considering the lack of risk factors and diagnostic instruments for tumor degeneration, the removal of AWE localization could be advisable, even though there was long average time between the trigger surgery and the tumor finding.
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Some authors describe other prognostic factors such as the size of the mass at the time of diagnosis, which could play a role in a better outcome, especially if the masses range between 4 and 9 cm.
“Some authors describe other prognostic factors such as the size of the mass at the time of diagnosis, which could play a role in a better outcome, especially if the masses range between 4 and 9 cm [63,64,65,66,67,68,69,70,71,72,73,74].”
From Malignancy in Abdominal Wall Endometriosis: Is There a Way to Avoid It? A Systematic Review (2024) · cites this paper as [72]
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Malignancy in Abdominal Wall Endometriosis: Is There a Way to Avoid It? A Systematic Review
Alaert, J., Lancelle, M., Timmermans, M., Tanos, P., Nisolle, M., & Karampelas, S. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13082282 · Cited by 9 · see citing works
- Authors
- Ferrari, F., Valenti, G., Forte, S., Ardighieri, L., Iraci Sareri, M., Barra, F., Sartori, E., & Odicino, F.
- Affiliations
- Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT)
- University of Catania (IT)
- University of Brescia (IT)
- Department of General Surgery and Medical‐Surgical Specialties – Institute of Obstetrics and Gynecology University of Catania Catania Italy
- Ospedale Policlinico San Martino (IT)
- Corresponding author
- Barra, Fabio
- ORCID
- Venue
- Journal of Obstetrics and Gynaecology Research
- Publisher
- Wiley
- Published
- 2021-01-13
- Volume
- 47
- Issue
- 4
- Pages
- 1243-1252
- ISSN
- 1341-8076 (ISSN-L)
- 1447-0756
- OpenAlex
- W3119034496
- Semantic Scholar
- bff8ec63ece79b30061af75d03e41696e8ff600d
- Cited by
- 8
- References
- 74
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 1
- FWCI
- 0.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of obstetrics and gynaecology research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
- Health Sciences › Medicine › Reproductive Medicine › Ovarian cancer diagnosis and treatment
- Keywords
- abdominal wall endometriosis, cesarean section scar, clear cell carcinoma, tumor degeneration, endometriosis surgery, bilateral oophorectomy, lymph node involvement, adjuvant chemotherapy, recurrence
- MeSH terms
- Cesarean Section, Cicatrix, Endometriosis, Female, Humans, Neoplasm Recurrence, Local, Pregnancy, Retrospective Studies, Abdominal Wall
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