Alaert Julie, Lancelle Mathilde, Timmermans Marie, Tanos Panayiotis, Nisolle Michelle, Karampelas Stavros
Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire Brugmann, Université Libre de Bruxelles, 1050 Brussels, Belgium.
Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire Tivoli, Université Libre de Bruxelles, 7100 La Louviere, Belgium.
J Clin Med. 2024 Apr 15;13(8):2282. doi: 10.3390/jcm13082282.
Malignant-associated abdominal wall endometriosis (AWE) is a rare pathology, likely to occur in 1% of scar endometriosis. The objectives of this study were to update the evidence on tumor degeneration arising from AWE to notify about the clinical characteristics, the different treatments offered to patients and their outcomes. A comprehensive systematic review of the literature was conducted. PubMed, Embase and Cochrane Library databases were used. Prospero (ID number: CRD42024505274). Out of the 152 studies identified, 63 were included, which involved 73 patients. The main signs and symptoms were a palpable abdominal mass (85.2%) and cyclic pelvic pain (60.6%). The size of the mass varied between 3 and 25 cm. Mean time interval from the first operation to onset of malignant transformation was 20 years. Most common cancerous histological types were clear cell and endometrioid subtypes. Most widely accepted treatment is the surgical resection of local lesions with wide margins combined with adjuvant chemotherapy. The prognosis for endometriosis-associated malignancy in abdominal wall scars is poor, with a five-year survival rate of around 40%. High rates of relapse have been reported. Endometrial implants in the abdominal wall should be considered as preventable complications of gynecological surgeries. Special attention should be paid to women with a history of cesarean section or uterine surgery.
恶性相关腹壁子宫内膜异位症（AWE）是一种罕见的病理情况，可能发生于1%的瘢痕子宫内膜异位症患者中。本研究的目的是更新有关AWE引发肿瘤退变的证据，以通报其临床特征、为患者提供的不同治疗方法及其结果。我们对文献进行了全面的系统综述。使用了PubMed、Embase和Cochrane图书馆数据库。Prospero（标识符：CRD42024505274）。在检索到的152项研究中，纳入了63项，涉及73例患者。主要体征和症状为可触及的腹部肿块（85.2%）和周期性盆腔疼痛（60.6%）。肿块大小在3至25厘米之间。从首次手术到发生恶性转化的平均时间间隔为20年。最常见的癌组织学类型是透明细胞和子宫内膜样亚型。最广泛接受的治疗方法是手术切除局部病灶并切缘广泛，联合辅助化疗。腹壁瘢痕中与子宫内膜异位症相关的恶性肿瘤预后较差，五年生存率约为40%。已有报道复发率较高。腹壁子宫内膜种植应被视为妇科手术可预防的并发症。对于有剖宫产或子宫手术史的女性应给予特别关注。
