Clear Cell Carcinoma of the Abdominal Wall as a Rare Complication of General Obstetric and Gynecologic Surgeries: 15 Years of Experience at a Large Academic Institution
Open accessAbstract
The objective of this article was to report the clinicopathological characteristics, treatment modalities, and outcomes of patients with clear cell carcinoma (CCC) of the abdominal wall. Medical records of six patients diagnosed with CCC of the abdominal wall between May 2003 and May 2018 at the National Taiwan University Hospital were reviewed. All patients had prior obstetric or gynecologic surgeries. The primary clinical presentation was enlarging abdominal masses at previous surgical scars. Four patients underwent initial/primary surgeries with/without adjuvant chemotherapy. One patient received neoadjuvant chemotherapy followed by surgical intervention and adjuvant chemotherapy, the other received chemotherapy and sequential radiotherapy without any surgical intervention. Two of four patients undergoing initial/primary surgeries had disease recurrence and the remaining two cases without initial surgery experienced disease progression during primary treatment. Inguinal lymph nodes were the most frequent sites of recurrence. In conclusion, previous obstetric or gynecologic surgery can be a risk factor for CCC of the abdominal wall. Complete resection of abdominal wall tumor and suspected intra-abdominal lesions with hysterectomy and bilateral inguinal lymph nodes dissection may be the primary treatment. Adjuvant chemotherapy would be considered for potential benefits. For patients without bilateral inguinal lymph nodes dissection, careful inguinal lymph node palpation during postoperative surveillance is necessary. More cases are still needed to elucidate the clinical management of this disease.
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Serum CA125 is not a valuable marker for the diagnosis of malignant transformation of endometriosis.
“Although serum CA125 it is an important indicator in advanced-stage ovarian cancer, where its value increases along with tumor size and is useful for predicting responses to chemotherapy, disease progression and recurrence, serum CA125 does not seem to be a valuable marker for the diagnosis of malignant transformation of endometriosis [18,34].”
From Malignancy in Abdominal Wall Endometriosis: Is There a Way to Avoid It? A Systematic Review (2024) · cites this paper as [34]
The Discussion (page not provided) reports that CA-125 was not elevated above 40 U/mL in the six abdominal-wall clear cell carcinoma cases and suggests it may not be an appropriate marker for that cancer. This supports a narrower, tentative point; it does not establish that CA-125 lacks diagnostic value for malignant transformation of endometriosis generally. The Discussion also notes that not all abdominal-wall clear cell carcinomas were associated with endometriosis. (LLM, conf=0.86)
Experimental — accuracy not yet measuredSerum CA125 is an important indicator in advanced-stage ovarian cancer, where its value increases along with tumor size and is useful for predicting responses to chemotherapy, disease progression and recurrence.
“Although serum CA125 it is an important indicator in advanced-stage ovarian cancer, where its value increases along with tumor size and is useful for predicting responses to chemotherapy, disease progression and recurrence, serum CA125 does not seem to be a valuable marker for the diagnosis of malignant transformation of endometriosis [18,34].”
From Malignancy in Abdominal Wall Endometriosis: Is There a Way to Avoid It? A Systematic Review (2024) · cites this paper as [34]
The Materials and Methods section says CA-125 was measured during follow-up and that sustained elevations could count as recurrence in patients with clear cell carcinoma of the abdominal wall. It does not address advanced-stage ovarian cancer, a relationship between CA-125 and tumor size, or prediction of chemotherapy response or disease progression. (LLM, conf=0.78)
Experimental — accuracy not yet measuredLarger cohorts have shown an increased risk of cancer in women with endometriosis.
“Larger cohorts have shown an increased risk of cancer in women with endometriosis [18,34].”
From Malignancy in Abdominal Wall Endometriosis: Is There a Way to Avoid It? A Systematic Review (2024) · cites this paper as [34]
The Introduction reports that cancers arise in an estimated 1% of women with ovarian endometriosis, and the Discussion describes studies linking endometriosis to ovarian clear cell carcinoma. But this paper reports a six-patient case series, not a larger cohort, and does not present a cohort comparison showing increased cancer risk in women with endometriosis generally. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThere is no specific tumor marker for the malignant transformation of endometriosis.
“Currently, there is no specific tumor marker for the malignant transformation of endometriosis.”
From Malignancy in Abdominal Wall Endometriosis: Is There a Way to Avoid It? A Systematic Review (2024) · cites this paper as [34]
The Introduction (page unavailable) describes histological criteria for diagnosing malignant transformation, but does not address whether a specific tumor marker exists. The Materials and Methods (page unavailable) describe CA-125 testing for recurrence after treatment, not for detecting malignant transformation. Searches for a specific tumor marker, biomarkers, and CA-125 found no passage establishing the claim. (LLM, conf=0.72)
Experimental — accuracy not yet measuredDue to limited publications on clear cell carcinoma arising from abdominal wall endometriosis, there are no clearly established protocols regarding adjuvant treatment, and an evaluation of prognostic factors is lacking.
“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.”
From Clear cell carcinoma arising from abdominal wall endometriosis—A report on two cases and literature review (2022) · cites this paper as [7]
Clear cell carcinoma arising from abdominal wall endometriosis is a rare, highly aggressive cancer with a propensity to recur or metastasize.
“Clear cell carcinoma arising from the abdominal wall endometriosis is a rare, highly aggressive cancer with a propensity to recur or metastasize.”
From Clear cell carcinoma arising from abdominal wall endometriosis—A report on two cases and literature review (2022) · cites this paper as [7]
Despite the use of adjuvant chemotherapy, disease recurrence or progression may still occur, as noted in our study.
“Despite the use of adjuvant chemotherapy, disease recurrence or progression may still occur, as noted in our study [7].”
From Clear cell carcinoma arising from abdominal wall endometriosis—A report on two cases and literature review (2022) · cites this paper as [7]
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References 28 · Cited by 22
- Authors
- Lai, Y.-L., Hsu, H.-C., Kuo, K.-T., Chen, Y.-L., Chen, C.-A., & Cheng, W.-F.
- Affiliations
- National Taiwan University Hospital (TW)
- National Taiwan University (TW)
- Corresponding author
- Chen, Yu-Li
- Venue
- International Journal of Environmental Research and Public Health
- Publisher
- MDPI AG
- Published
- 2019-02-14
- Volume
- 16
- Issue
- 4
- Pages
- 552
- ISSN
- 1660-4601 (ISSN-L)
- PMC
- PMC6406533
- OpenAlex
- W2914782482
- Cited by
- 22
- References
- 28
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 2 · 2022: 4 · 2021: 6 · 2020: 4
- FWCI
- 2.57
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Sarcoma Diagnosis 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
- clear cell carcinoma, abdominal wall, postoperative complications, obstetric and gynecologic surgery, postoperative scarring, inguinal lymph node metastasis, adjuvant chemotherapy, neoadjuvant chemotherapy, hysterectomy, lymph node dissection, tumor resection, postoperative follow-up, clinicopathological features
- MeSH terms
- Adult, Aged, Female, Hospitals, University, Humans, Middle Aged, Pregnancy, Gynecologic Surgical Procedures, Obstetric Surgical Procedures, Taiwan, Adenocarcinoma, Clear Cell, Abdominal Wall
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