Clear Cell Carcinoma of the Abdominal Wall: An Aggressive Endometriosis-Associated Malignant Disease

Endometriosis rarely affects the abdominal wall and typically occurs following surgery, like uterine procedures or, more commonly, cesarean sections. There have been a few instances of endometriosis evolving into malignant clear cell carcinoma. Our goal was to examine all relevant cases documented in the literature and introduce a new case. In this article, we analyze reported occurrences of clear cell carcinoma in the abdominal wall and share the case of a 45-year-old woman with a mass on her front abdominal wall. An initial biopsy revealed clear cell carcinoma of the female genital tract. In our facility, she underwent extensive surgery involving the removal of the mass along with sections of the abdominal wall, uterus, fallopian tubes, ovaries, omentum, suspicious lymph nodes, and reconstruction of the abdominal wall using a double-sided mesh. She had a smooth recovery after the operation, but a month later, prior to commencing chemotherapy, she developed metastases in the liver and lungs. She was treated with systemic therapy and, after six months, displayed a positive response with some reduction in the disease. As of 15 months post-surgery, she is doing well under ongoing treatment. Clear cell carcinoma of the abdominal wall is an uncommon and aggressive cancer with a grim outlook. Physicians should be wary of the potential for malignancy in women with an abdominal wall mass and a history of gynecological surgeries, especially cesarean sections.