Clear-cell carcinoma originating from cesarean section scar: two case reports

Hashemi, S.R. and Morshedi, M. and Maghsoudi, H. and Esmaeilzadeh, A. and Alkatout, I. (2021) Clear-cell carcinoma originating from cesarean section scar: two case reports. Journal of Medical Case Reports, 15 (1).


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Background: Clear-cell carcinoma arising from the surgical cesarean section scar is very infrequent. The present study reports two patients with clear-cell carcinoma arising from an abdominal wall scar 20 and 23 years after their last cesarean section. Case presentation: Both Iranian patients had prior cesarean sections nearly 20 years earlier. Patients 1 and 2 had transverse and vertical abdominal incisions, respectively. The initial clinical presentation was a huge lower abdominal mass at the site of the previous cesarean section scar. Both patients underwent abdominal wall mass biopsy. The histological analysis revealed the presence of malignancy. Both patients underwent full-thickness resection of the abdominal wall mass. All surgical margins were tumor-free; however, patient 1 had a very narrow tumor-free margin near the pubic symphysis. As the imaging report of patient 2 revealed the presence of a pelvic mass, the exploration of the intraperitoneal space, simple total abdominal hysterectomy (TAH), bilateral salpingo-oophorectomy (BSO), and the excision of enlarged pelvic lymph nodes were performed during the surgery. Six cycles of paclitaxel and carboplatin every 3 weeks as adjuvant chemotherapy was administered for both patients after the surgery. One of the patients had disease recurrence 5 months after the termination of chemotherapy, and the other is still disease-free. These two patients had similar pathology and received a similar initial adjuvant treatment; however, they were different in terms of the direction of tumor spread, tumor distance from the pubic symphysis, status of tumor margins, and surgical procedures. Conclusions: We encountered distinct prognoses in the clear-cell carcinoma of cesarean section scars presented herein. The researchers can recommend complete surgical excision of the abdominal wall mass with wide tumor-free margins, exploration of the abdominopelvic space, TAH, and BSO during the first surgery. © 2021, The Author(s).

Item Type: Article
Additional Information: cited By 0
Uncontrolled Keywords: bevacizumab; carboplatin; cisplatin; doxorubicin; gemcitabine; paclitaxel; vinorelbine tartrate, abdominal hysterectomy; abdominal pain; abdominal wall defect; abdominal wall hernia; adult; Article; ascites tumor; cancer adjuvant therapy; cancer recurrence; case report; cesarean section; clear cell carcinoma; clinical article; echography; end to end anastomosis; female; follow up; histopathology; human; human tissue; incisional biopsy; Iranian people; laparotomy; lymph node dissection; middle aged; multiple cycle treatment; nausea; needle biopsy; pain severity; pelvis lymph node; pelvis tumor; positron emission tomography-computed tomography; priority journal; salpingooophorectomy; scar; self examination; tumor growth; tumor volume; abdominal wall; cesarean section; endometriosis; Iran; pathology; pregnancy; scar; surgery; tumor recurrence, Abdominal Wall; Cesarean Section; Cicatrix; Endometriosis; Female; Humans; Iran; Neoplasm Recurrence, Local; Pregnancy
Subjects: WP Gynecology
WQ Obstetrics
Depositing User: eprints admin
Date Deposited: 11 Aug 2021 07:20
Last Modified: 11 Aug 2021 07:20

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