Endometrioid adenocarcinoma arising from abdominal wall endometriosis in the appendectomy scar: A case report


We report a very rare case of endometrioid adenocarcinoma arising from abdominal wall endometriosis in the appendectomy scar. A 47-year-old woman visited the surgical department, since she had a gradually growing and painful tumor both in an appendectomy scar and at an umbilical site. She underwent appendectomy at age 18 years, and noticed the tumor at age 22 years. Partial tumor resection was performed in that department, and the pathology revealed endometrioid adenocarcinoma. She was referred to our department for radical therapy. Tumors in the both sites were dissected together with some swelling lymph nodes in our department. A pathological diagnosis of the tumor in the umbilical site showed only benign endometriosis. In contrast, the tumor in the appendectomy scar showed benign endometriosis, atypical endometriosis and well differentiated endometrioid adenocarcinoma. Resected lymph nodes also contained endometrioid adenocarcinoma, and were diagnosed as metastases. It was concluded that the endometrioid adenocarcinoma in the tumor of the appendectomy scar was a malignant transformation arising from abdominal wall endometriosis from the pathological findings. Since the operation, adjuvant and maintenance chemotherapy with paclitaxel and carboplatin had been administered for 3 years. She is free of disease 3.5 years after the operation.

Share and Cite:

Hayashi, M. , Shoda, A. , Kosaka, N. , Kojima, M. , Masawa, N. and Fukasawa, I. (2013) Endometrioid adenocarcinoma arising from abdominal wall endometriosis in the appendectomy scar: A case report. Open Journal of Obstetrics and Gynecology, 3, 556-560. doi: 10.4236/ojog.2013.37100.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Horton, J.D., DeZee, K.J., Ahnfeldt, E.P. and Wagner, M. (2008) Abdominal wall endometriosis: A surgeon’s perspective and review of 445 cases. The American Journal of Surgery, 196, 207-212. doi:10.1016/j.amjsurg.2007.07.035
[2] Efremidou, E.I., Kouklakis, G., Mitrakas, A., Liratzopoulos, N. and Polychronidis, A.C. (2012) Primary umbilical endometrioma: A rare case of spontaneous abdominal wall endometriosis. International Journal of General Medicine, 5, 999-1002. doi:10.2147/IJGM.S37302
[3] Jafferbhoy, S., Symeonides, P., Levy, M. and Shiwani, M.H. (2013) Chronic umbilical discharge: An unusual presentation of endometriosis. Sultan Qaboos University Medical Sciences Journal, 13, 143-146.
[4] Benoit, L., Arnould, L., Cheynel, N., Diane, B., Causeret, S., Machado, A., Collin, F., Fraisse, J. and Cuisenier, J. (2006) Malignant extraovarian endometriosis: A review. European Journal of Surgical Oncology, 32, 6-11. doi:10.1016/j.ejso.2005.08.011
[5] Ulrich, U., Rhiem, K., Kaminski, M., Wardelmann, E., Trog, D., Valter, M. and Richter, O.N. (2005) Parametrial and rectovaginal adenocarcinoma arising from endometriosis. International Journal of Gynecological Cancer, 15, 1206-1209. doi:10.1111/j.1525-1438.2005.00184.x
[6] Bats, A.S., Zafrani, Y., Pautier, P., Duvillard, P. and Morice, P. (2008) Malignant transformation of abdominal wall endometriosis to clear cell carcinoma: Case report and review of the literature. Fertility and Sterility, 90, 1197.e13-1197.e16. doi:10.1016/j.fertnstert.2007.08.080
[7] Li, X., Yang, J., Cao, D., Lang, J., Chen, J. and Shen, K. (2012) Clear-cell carcinoma of the abdominal wall after cesarean delivery. Obstetrics & Gynecology, 120, 445-448. doi:10.1097/AOG. 0b013e31824da6fe
[8] Shalin, S.C., Haws, A.L., Carter, D.G. and Zarrin-Khameh, N. (2012) Clear cell adenocarcinoma arising from endometriosis in abdominal wall cesarean section scar: A case report and review of the literature. Journal of Cutaneous Pathology, 39, 1035-1041. doi:10.1111/j.1600-0560.2012.01982.x
[9] Sawazaki, H., Goto, H., Takao, N., Taki, Y. and Takeuchi, H. (2012) Clear cell adenocarcinoma arising from abdominal wall endometriosis mimicking urachal tumor. Urology, 79, 84-85. doi:10.1016/j. urology. 2011.02.034
[10] Mert, I., Semaan, A., Kim, S., Ali-Fehmi, R. and Morris, R.T. (2012) Clear cell carcinoma arising in the abdominal wall: Two case reports and literature review. American Journal of Obstetrics & Gynecology, 207, 7-9. doi:10.1016/j.ajog.2012.05.029
[11] Sampson, J.A. (1925) Endometrial carcinoma of the ovary, arising in endometrial tissue in that organ. Archives of Surgery, 10, 1-2. doi:10.1001/archsurg.1925.01120100007001
[12] Wang, N.P., Zee, S., Zarbo, R.J., Baccchi, C.E., Gown, A.M. (1995) Coordinate expression of cytokeratins 7 and 20 defines unique subsets of carcinomas. Applied Immunohistochemistry & Molecular Morphology, 3, 99-107.
[13] Chu, P., Wu, E. and Weiss, L.M. (2000) Cytokeratin 7 and cytokeratin 20 expression in epithelial neoplasms: A survey of 435 cases. Modern Pathology, 13, 962-972. doi:10.1038/modpathol.3880175
[14] Scott, R. (1953) Malignant changes in endometriosis. Obstetrics & Gynecology, 2, 283-289.
[15] Mostoufizadeh, M. and Scully, R.E. (1980) Malignant tumors arising in endometriosis. Clinical Obstetrics and Gynecology, 23, 951-963.
[16] Fukunaga, M., Nomura, K., Ishikawa, E. and Ushigome, S. (1997) Ovarian atypical endometriosis: Its close association with malignant epithelial tumours. Histopathology, 30, 249-255. doi:10.1046/j.1365-2559.1997.d01-592.x
[17] Terada, T. (2012) Endometrioid adenocarcinoma of the ovary arising in atypical endometriosis. International Journal of Clinical and Experimental Pathology, 5, 924-927.

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.