Clear Cell Carcinoma of the Abdominal Wall as a Rare Complication of General Obstetric and Gynecologic Surgeries: 15 Years of Experience at a Large Academic Institution

Yen-Ling Lai, Heng-Cheng Hsu, Kuan-Ting Kuo, Yu-Li Chen, Chi-An Chen and Wen-Fang Cheng
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Yen-Ling Lai: Department of Obstetrics and Gynecology; National Taiwan University Hospital, Taipei 100, Taiwan
Heng-Cheng Hsu: Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan
Kuan-Ting Kuo: Department of Pathology and Graduate Institute of Pathology, College of Medicine, National Taiwan University, Taipei 100, Taiwan
Yu-Li Chen: Department of Obstetrics and Gynecology; National Taiwan University Hospital, Taipei 100, Taiwan
Chi-An Chen: Department of Obstetrics and Gynecology; National Taiwan University Hospital, Taipei 100, Taiwan
Wen-Fang Cheng: Department of Obstetrics and Gynecology; National Taiwan University Hospital, Taipei 100, Taiwan

IJERPH, 2019, vol. 16, issue 4, 1-12

Abstract: The objective of this article was to report the clinicopathological characteristics, treatment modalities, and outcomes of patients with clear cell carcinoma (CCC) of the abdominal wall. Medical records of six patients diagnosed with CCC of the abdominal wall between May 2003 and May 2018 at the National Taiwan University Hospital were reviewed. All patients had prior obstetric or gynecologic surgeries. The primary clinical presentation was enlarging abdominal masses at previous surgical scars. Four patients underwent initial/primary surgeries with/without adjuvant chemotherapy. One patient received neoadjuvant chemotherapy followed by surgical intervention and adjuvant chemotherapy, the other received chemotherapy and sequential radiotherapy without any surgical intervention. Two of four patients undergoing initial/primary surgeries had disease recurrence and the remaining two cases without initial surgery experienced disease progression during primary treatment. Inguinal lymph nodes were the most frequent sites of recurrence. In conclusion, previous obstetric or gynecologic surgery can be a risk factor for CCC of the abdominal wall. Complete resection of abdominal wall tumor and suspected intra-abdominal lesions with hysterectomy and bilateral inguinal lymph nodes dissection may be the primary treatment. Adjuvant chemotherapy would be considered for potential benefits. For patients without bilateral inguinal lymph nodes dissection, careful inguinal lymph node palpation during postoperative surveillance is necessary. More cases are still needed to elucidate the clinical management of this disease.

Keywords: endometriosis; malignant transformation; clear cell carcinoma; abdominal wall; inguinal lymph node; cesarean section (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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