Abstract

Background: Endometriosis occurring in a surgical scar is well recognized and occurs mainly in patients with a history of hysterectomy or Caesarean section. Scar endometriosis, as well as endometriosis at other sites, can undergo malignant change. Clear cell carcinoma of the endometrium is a very rare and highly malignant neoplasm that accounts for less than 5% of endometrial carcinoma.

Case presentation: We report a very rare case of clear cell adenocarcinoma arising from endometriosis of the abdominal scar. We must pay more attention on the following points in the surgical treatment of clear cell carcinoma: (1) Extensively resect tumors as far as possible; (2) Surgical treatment of clear cell carcinoma would easily result in poor wound healing especially in the patients receiving chemotherapy or radiotherapy because of extensive soft tissue stripping .

Conclusion: The patient died only 25 months after she was first diagnosed with the cancer.

Lessons: This case highlights the difficulties in preoperative diagnosis as well as the poor prognosis of these tumors. Accurate diagnosis of a lump within a scar is important to define the prognosis and treatment. These therapeutic principles are increasingly being applied to patients presenting with tumors greater than 5 cm and negative lymph nodes or even smaller tumors, who are considered to have operable disease and a better outcome. Early recognition and prompt treatment can be essential to these patients' survival.

Keywords: Endometriosis; Clear cell carcinoma; Case report; Abdominal wall; Caesarean section