Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2022; 10(31): 11567-11573
Published online Nov 6, 2022. doi: 10.12998/wjcc.v10.i31.11567
Mass-like extragonadal endometriosis associated malignant transformation in the pelvis: A rare case report
Ping Chen, Ya Deng, Qiao-Qiao Wang, Hong-Wei Xu
Ping Chen, Ya Deng, Qiao-Qiao Wang, Hong-Wei Xu, Department of Obstetrics and Gynecology, Shaoxing Second Hospital, Shaoxing 312000, Zhejiang Province, China
Author contributions: Deng Y and Wang QQ contributed to conceptualization; Wang QQ contributed to data curation; Chen P contributed to supervision; Deng Y and Xu HW contributed to original draft writing; Chen P contributed to manuscript review and editing; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this case report and the accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: Ping Chen, MD, Professor, Department of Obstetrics and Gynecology, Shaoxing Second Hospital, No. 123 Yanan Road, Shaoxing 312000, Zhejiang Province, China. 592058001@qq.com
Received: June 10, 2022
Peer-review started: June 10, 2022
First decision: June 27, 2022
Revised: July 1, 2022
Accepted: September 23, 2022
Article in press: September 23, 2022
Published online: November 6, 2022
Abstract
BACKGROUND

Endometriosis affects approximately 10% of reproductive-age women, however, endometriosis associated malignant transformation is rare and is often report as a rare case.

CASE SUMMARY

Herein, we report of a 49-year-old female patient who suffered from severe left lower abdominal pain and imaging examination revealed an irregular mass in the left iliac fossa. Histopathological examination revealed main undifferentiated adenocarcinoma with a few typical endometrial epithelial and stromal tissues in the adjacent area. Combined with the immunohistochemical staining and the negative intra- or postoperative results from exploratory laparotomy, gastroscopy, enteroscopy and positron emission tomography, the tumor was considered to be derived from endometriosis. The patient underwent hysterectomy, bilateral salpingectomy, bilateral ovariectomy, and multipoint biopsy of the pelvic peritoneum. Subsequent radiotherapy and chemotherapy were performed. The patient recovered well post-operation and there was no evidence of recurrence after 10 mo of follow-up via computed tomography and magnetic resonance imaging.

CONCLUSION

This case highlights a rare presentation of mass-like extragonadal endometriosis associated malignant transformation in the pelvis. Endometriosis associated malignant transformation is rare and difficult to diagnose in clinical settings, with diagnoses depending on pathological results and the exclusion of metastasis from other organs. Fortunately, patients are often diagnosed at younger ages, as well as at early stages; thus they generally have relatively favorable prognoses.

Keywords: Endometriosis, Mass, Malignant, Adenocarcinoma, Case report

Core Tip: Endometriosis associated malignant transformation is rare and difficult to diagnose in clinical settings. In this study, we report of a rare case of a female patient with a 5 cm irregular mass in the left iliac fossa and without any endometriotic lesions in the pelvic cavity. Histopathological examination revealed main undifferentiated adenocarcinoma with a few typical endometrial epithelial and stromal tissues in the adjacent area. The patient underwent hysterectomy, bilateral salpingectomy and bilateral ovariectomy followed by subsequent radiotherapy and chemotherapy. She recovered well post-operation with no evidence of recurrence after 10 mo. A review of the literature concerning endometriosis associated malignant transformation is also presented.