Leng J, Lang J, Guo L, Li H, Liu Z
Department of Gynecology and Obstetrics, Peking Union Medical College Hospital, CAM&PUMC, #1 Shuaifuyuan, Wangfujing, Beijing 100730, China.
Int J Gynecol Cancer. 2006 Jan-Feb;16(1):432-5. doi: 10.1111/j.1525-1438.2006.00199.x.
Malignant change of endometriosis in a cesarean scar (CS) is rare. We report a case of carcinosarcoma arising from atypical endometriosis in a CS scar, which was successfully treated with complete excision of the lesion and repair of the abdominal wall defect with autologous skin-muscle flap graft. A 41-year-old woman presented with a recurrent endometriosis in a CS scar. Within 16 years it changed from benign to atypical endometriosis and finally to carcinosarcoma after three operations. Complete excision of the tumor was performed, with a big defect of abdominal wall successfully repaired by autologous pedicle skin-muscle graft. The diagnosis of carcinosarcoma arising from atypical endometriosis was confirmed histologically. The lesion recurred 6 months after the fourth operation. She died of disease 15 months after the fourth operation. This case demonstrated that long-standing recurrent scar endometriosis could undergo malignant changes and should be made aware. The primary treatment is complete surgical excision.
剖宫产瘢痕（CS）内异症恶变罕见。我们报告1例CS瘢痕非典型内异症发生的癌肉瘤，通过病变完整切除及自体皮肌瓣移植修复腹壁缺损成功治疗。1例41岁女性，CS瘢痕处复发性内异症。16年内，经3次手术后，病变从良性转变为非典型内异症，最终发展为癌肉瘤。行肿瘤完整切除，腹壁大缺损通过自体带蒂皮肌移植成功修复。组织学确诊为非典型内异症发生的癌肉瘤。第4次手术后6个月病变复发。第4次手术后15个月患者死于该疾病。该病例表明，长期复发性瘢痕内异症可发生恶变，应予以重视。主要治疗方法为手术完整切除。
