title: Carcinosarcoma arising from atypical endometriosis in a cesarean section scar.
abstract: Malignant change of endometriosis in a cesarean scar (CS) is rare. We report a case of carcinosarcoma arising from atypical endometriosis in a CS scar, which was successfully treated with complete excision of the lesion and repair of the abdominal wall defect with autologous skin-muscle flap graft. A 41-year-old woman presented with a recurrent endometriosis in a CS scar. Within 16 years it changed from benign to atypical endometriosis and finally to carcinosarcoma after three operations. Complete excision of the tumor was performed, with a big defect of abdominal wall successfully repaired by autologous pedicle skin-muscle graft. The diagnosis of carcinosarcoma arising from atypical endometriosis was confirmed histologically. The lesion recurred 6 months after the fourth operation. She died of disease 15 months after the fourth operation. This case demonstrated that long-standing recurrent scar endometriosis could undergo malignant changes and should be made aware. The primary treatment is complete surgical excision.
authors.affiliation: Department of Gynecology and Obstetrics, Peking Union Medical College Hospital, CAM&PUMC, #1 Shuaifuyuan, Wangfujing, Beijing 100730, China. lengjenny@vip.sina.com
authors.forename: J
authors.initials: J
authors.lastname: Leng
authors.forename: J
authors.initials: J
authors.lastname: Lang
authors.forename: L
authors.initials: L
authors.lastname: Guo
authors.forename: H
authors.initials: H
authors.lastname: Li
authors.forename: Z
authors.initials: Z
authors.lastname: Liu
mesh_terms: D034861:Abdominal Wall; D000328:Adult; D001707:Biopsy, Needle; D002296:Carcinosarcoma / Q000473:pathology* / Q000601:surgery; D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D002585:Cesarean Section / Q000009:adverse effects*; D017439:Cicatrix, Hypertrophic / Q000209:etiology / Q000473:pathology*; D004715:Endometriosis / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D011247:Pregnancy; D018570:Risk Assessment; D013524:Surgical Flaps; D016896:Treatment Outcome