A rare case of malignant transformation of endometrioma: a case report

A rare case of malignant transformation of endometrioma: a case report Endometriosis of the abdominal wall, arising in a surgical scar, is a rare event. Its malignant transformation is an uncommon complication. We report a case of a suspected endometrioma in a caesarean section scar that was radically resected. The histopathologic diagnosis, surprisingly, was metastasis from papillary cystadenocarcinoma. A hysterosalpingo-oophorectomy was performed. One year later, she presented with a mass involving the left rectus abdominis muscle. Histopathologic re-evaluation revealed a carcinoma on endometriosis. A wide resection of the abdominal wall was performed, and reconstruction was undertaken with a Goretex mesh and two tensor fascia lata musculocutaneous flaps. Histopathological diagnosis was adenocarcinoma with invasion into the parietal peritoneum. Despite aggressive surgical treatment and adjuvant chemotherapy, 5 months after surgery, she presented peritoneal dissemination of the disease. The diagnosis of malignancy arising on endometrioma is often difficult because of the lack of pathognomonic signs. Prognosis is strictly related to the time of diagnosis. We believe that an early and aggressive treatment on the sole suspicion of an endometrial origin of an abdominal mass would allow a much earlier diagnosis and treatment for those patients, improving their prognosis, which is otherwise very poor. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Plastic Surgery Springer Journals

A rare case of malignant transformation of endometrioma: a case report

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Publisher
Springer Journals
Copyright
Copyright © 2011 by Springer-Verlag
Subject
Medicine & Public Health; Plastic Surgery
ISSN
0930-343X
eISSN
1435-0130
D.O.I.
10.1007/s00238-010-0489-2
Publisher site
See Article on Publisher Site

Abstract

Endometriosis of the abdominal wall, arising in a surgical scar, is a rare event. Its malignant transformation is an uncommon complication. We report a case of a suspected endometrioma in a caesarean section scar that was radically resected. The histopathologic diagnosis, surprisingly, was metastasis from papillary cystadenocarcinoma. A hysterosalpingo-oophorectomy was performed. One year later, she presented with a mass involving the left rectus abdominis muscle. Histopathologic re-evaluation revealed a carcinoma on endometriosis. A wide resection of the abdominal wall was performed, and reconstruction was undertaken with a Goretex mesh and two tensor fascia lata musculocutaneous flaps. Histopathological diagnosis was adenocarcinoma with invasion into the parietal peritoneum. Despite aggressive surgical treatment and adjuvant chemotherapy, 5 months after surgery, she presented peritoneal dissemination of the disease. The diagnosis of malignancy arising on endometrioma is often difficult because of the lack of pathognomonic signs. Prognosis is strictly related to the time of diagnosis. We believe that an early and aggressive treatment on the sole suspicion of an endometrial origin of an abdominal mass would allow a much earlier diagnosis and treatment for those patients, improving their prognosis, which is otherwise very poor.

Journal

European Journal of Plastic SurgerySpringer Journals

Published: Dec 1, 2011

References

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