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
Journal
International Journal of Environmental Research and Public Health
Date Issued
2019
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. ? 2019 by the authors. Licensee MDPI, Basel, Switzerland.
Other Subjects
bevacizumab; CA 125 antigen; carboplatin; doxorubicin; gemcitabine; paclitaxel; cancer; chemotherapy; pregnancy; reproductive disorder; tumor; abdominal mass; abdominal wall clear cell carcinoma; adjuvant chemotherapy; adult; Article; cancer growth; cancer radiotherapy; cancer recurrence; clear cell carcinoma; clinical article; clinical feature; disease free survival; female; gynecologic surgery; human; hysterectomy; lymph node dissection; neoadjuvant chemotherapy; nuclear magnetic resonance imaging; outcome assessment; overall survival; postoperative period; retrospective study; treatment outcome; treatment planning; university hospital; x-ray computed tomography; abdominal wall; adenocarcinoma; aged; gynecologic surgery; middle aged; obstetric operation; pathophysiology; pregnancy; Taiwan; Taiwan; Abdominal Wall; Adenocarcinoma, Clear Cell; Adult; Aged; Female; Gynecologic Surgical Procedures; Hospitals, University; Humans; Middle Aged; Obstetric Surgical Procedures; Pregnancy; Taiwan
Type
journal article