Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 6, 2022; 10(19): 6702-6709
Published online Jul 6, 2022. doi: 10.12998/wjcc.v10.i19.6702
Plastic surgery for giant metastatic endometrioid adenocarcinoma in the abdominal wall: A case report and review of literature
Jing-Yuan Wang, Zhi-Qi Wang, Si-Chen Liang, Guang-Xue Li, Jing-Li Shi, Jian-Liu Wang
Jing-Yuan Wang, Zhi-Qi Wang, Si-Chen Liang, Jian-Liu Wang, Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
Guang-Xue Li, Department of Plastic Surgery, Peking University People’s Hospital, Beijing 100044, China
Jing-Li Shi, Department of Pathology, Peking University People’s Hospital, Beijing 100044, China
Author contributions: Wang JY participated in the management of the patient and wrote the manuscript; Wang ZQ participated in the medical management of the patient; Liang SC and Wang JL were involved in the surgical management of the patient; Li GX carried out plastic surgery; Shi JL performed immunohistochemistry and contributed to pathological characterization.
Supported by This work was supported by the National Key Technology R&D Program of China, No. 2019YFC1005200, and No. 2019YFC1005201; the Natural Science Foundation of Beijing, No. 7202213; and the National Natural Science Foundation of China; No. 82072861, 81672571, and 81874108.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Liu Wang, MD, PhD, Doctor, Professor, Surgeon, Surgical Oncologist, Department of Obstetrics and Gynecology, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing 100044, China. wangjianliu1203@163.com
Received: January 23, 2022
Peer-review started: January 23, 2022
First decision: March 23, 2022
Revised: April 1, 2022
Accepted: May 8, 2022
Article in press: May 8, 2022
Published online: July 6, 2022
Abstract
BACKGROUND

Endometrial cancer (EC) is a common gynecological malignancy, but metastasis to the abdominal wall is extremely rare. Therefore, an appropriate treatment approach for large metastatic lesions with infection remains a great challenge.

CASE SUMMARY

We report the case of a 65-year-old woman who developed abdominal metastasis of endometrioid adenocarcinoma, as defined by International Obstetrics and Gynecology stage II, in which the lesion was complicated by infection. A right hemicolectomy was performed for colon metastasis in relation to her initial gynecological cancer 3 years ago. When admitted to our department, a complete resection of the giant abdominal wall lesion was performed, and a Bard composite mesh was used to reconstruct the abdominal wall. A local flap was used to close the resultant large defect in the external covering of the abdomen. The patient underwent chemotherapy following cytoreductive surgery. Pathology revealed metastasis of EC, and molecular subtyping showed copy number high of TP53 mutation, implying a poor prognosis.

CONCLUSION

When EC patients develop giant abdominal wall metastasis, a plastic surgeon should be included before contemplating resection of tumors.

Keywords: Abdominal metastasis, Infection, Endometrial cancer, Reconstruction, Mesh, Case report

Core Tip: This report presents a rare case of endometrioid adenocarcinoma with extensive abdominal wall metastasis complicated by infection, and highlights the design of the reconstruction of the abdominal wall after resection. A plastic surgeon should be included in the planning before contemplating resection of large tumors.