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Exclusive nodal recurrence after treatment of degenerated parietal endometriosis
Nicolas Bourdel1, Maud Durand, Pierre Gimbergues
1CHU Clermont Ferrand, Department of Obstetrics and Gynecology, La Polyclinique, Clermont-Ferrand, France. nbourdel@chu-clermontferrand.fr
Objective:
To report a case of endometriosis degenerated into clear cell carcinoma with positron-emission tomography (PET) scan staging.
Design:
Case report.
Setting:
University hospital.
Patient(S):
A 43-year-old woman diagnosed with endometriosis degenerated into clear cell carcinoma with nodal metastasis at the initial diagnosis and exclusive nodal recurrence 6 months after surgery.
Intervention(S):
Resection of the mass with partial resection of the pubic symphysis and bilateral external iliac lymphadenectomy. Forty-five days later, hysterectomy with bilateral adnexectomy and then adjuvant chemotherapy and abdominal-pelvic radiotherapy.
Main Outcome Measure(S):
The PET scan showed positive lymph nodes in the cervical, supraclavicular, bilateral axillary, bilateral inguinal, and lumbar-aortic regions.
Result(S):
The patient experienced a tumor recurrence after 6 months. After surgical management, she was scheduled to receive six cycles of rescue chemotherapy. She died 22 months after the initial diagnosis.
Conclusion(S):
The use of PET scan could allow better staging at the initial diagnosis and improve follow-up in such patients. The treatment of this entity is based on radical surgery associated with adjuvant chemotherapy and radiotherapy, but the results are not satisfactory.
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