Alberto V O, Lynch M, Labbei F N, Jeffers M
Dept of Surgery, Naas General Hospital, Co Kildare.
Ir J Med Sci. 2006 Jan-Mar;175(1):69-71. doi: 10.1007/BF03169006.
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. Endometrioid carcinoma is the most common malignant tumour arising in endometriosis. However, clear cell carcinoma can also occur but is unusual.
To discuss the diagnosis and management of such a case.
We report a case of primary clear cell carcinoma in endometriosis of a Caesarean section scar and review the literature.
The patient presented with a large right lower quadrant abdominal wall mass within a Caesarean section scar. Histological examination revealed a clear cell carcinoma. The patient had a prior history of pelvic endometriosis. According to the Irish National Cancer Registry, this is the first reported case of a primary abdominal wall clear cell carcinoma developing within a Caesarean section scar in Ireland.
Any lesion occurring in a Caesarean section scar with a history of previous endometriosis cannot be underestimated and warrants careful clinical follow-up and histological evaluation as appropriate.
手术瘢痕内发生的子宫内膜异位症已得到充分认识，主要发生在有子宫切除术或剖宫产史的患者中。瘢痕子宫内膜异位症以及其他部位的子宫内膜异位症都可能发生恶变。子宫内膜样癌是子宫内膜异位症中最常见的恶性肿瘤。然而，透明细胞癌也可能发生，但较为罕见。
探讨此类病例的诊断和治疗。
我们报告一例剖宫产瘢痕子宫内膜异位症中发生原发性透明细胞癌的病例，并复习相关文献。
患者剖宫产瘢痕处右侧下腹部出现一个较大的腹壁肿块。组织学检查显示为透明细胞癌。患者既往有盆腔子宫内膜异位症病史。根据爱尔兰国家癌症登记处的数据，这是爱尔兰首例报道的在剖宫产瘢痕内发生的原发性腹壁透明细胞癌病例。
对于有既往子宫内膜异位症病史的剖宫产瘢痕处出现的任何病变都不能低估，需要进行仔细的临床随访并酌情进行组织学评估。
