Endometriosis-associated Clear Cell Carcinoma of the Abdominal Wall after Caesarean Section: A Case Report and Review of the Literature
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BACKGROUND/AIM: Clear cell carcinoma of the abdominal wall is a sporadic event. To date, about thirty cases have been reported in the literature. This article provides a case report and literature review of an infrequent occurrence with poor prognosis. CASE REPORT: A 45-year-old woman with pelvic pain and an abdominal mass came to our attention. Her medical history was notable for two previous cesarean sections. Physical examination revealed a smooth, multilocular mass measuring about 20 cm, arising from the previous surgical scar. Histology revealed clear-cell carcinoma resulting from the transformation of abdominal wall endometriosis. Given the disease extent, the patient underwent front-line chemotherapy. After several and multiple chemotherapy regimens, there was a disease progression that resulted in the death of the patient in 7 months. The literature review showed that a previous cesarean section was present in 91% of cases. Besides, approximately 26.5% of women died within 12 months of being diagnosed. The mean age of women was 45.88 years, while the average size of the lesion was 11 cm. CONCLUSION: Clear cell carcinoma is a rare but occurring event. Middle-aged women showing an abdominal wall mass in close relation with a surgical scar from a previous cesarean section must be promptly investigated. Treatment options usually include surgery and chemotherapy with poor results.
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In 58-64% of cases, there was an absence of a transition zone.
“Giannella et al. (2020) pointed out that in 58–64% of cases, there was an absence of a transition zone, making diagnosis even more difficult [25].”
From Malignancy in Abdominal Wall Endometriosis: Is There a Way to Avoid It? A Systematic Review (2024) · cites this paper as [25]
The Discussion reports endometriotic tissue in over 60% of cases and says no endometrial tissue was found in the authors’ case. Neither that passage nor the additional passages retrieved for “transition zone” and the 58–64% figure reports how often a transition zone was absent. (LLM, conf=0.73)
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References 44 · Cited by 22
- Authors
- GIANNELLA, L., SERRI, M., MACCARONI, E., DI GIUSEPPE, J., CARPINI, G. D., BERARDI, R., SOPRACORDEVOLE, F., & CIAVATTINI, A.
- Affiliations
- Marche Polytechnic University (IT)
- Centro di Riferimento Oncologico (IT)
- ORCID
- Venue
- In Vivo
- Published
- 2020
- Volume
- 34
- Issue
- 4
- Pages
- 2147-2152
- ISSN
- 0258-851X (ISSN-L)
- 1791-7549
- PMC
- PMC7439887
- OpenAlex
- W3039514827
- Cited by
- 22
- References
- 44
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 2 · 2022: 6 · 2021: 5
- FWCI
- 2.87
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- In Vivo (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Università Politecnica delle Marche (Università Politecnica delle Marche) (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Metastasis and carcinoma case studies
- Health Sciences › Medicine › Reproductive Medicine › Ovarian cancer diagnosis and treatment
- Keywords
- cesarean section, postoperative scarring, malignant transformation, pelvic pain, abdominal mass, chemotherapy, prognosis, rare malignancy
- MeSH terms
- Cesarean Section, Cicatrix, Endometriosis, Female, Humans, Middle Aged, Pregnancy, Adenocarcinoma, Clear Cell, Abdominal Wall
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