Endometriosis of a surgical scar is rare and occurs mainly when a hysterectomy or Cesarean section was performed. We describe a 54-year-old woman with a large suprapubic mass as a definite case of a endomerioid carcinoma developing within the scar endometriosis following Cesarean section. Scar endometriosis, as well as endometriosis at other sites, can turn malignant. Endometrioid carcinoma is the most common histological pattern of malignant tumor arising in endometriosis. But clear cell carcinoma is very unusual. A case of primary clear cell carcinoma in endometriosis of a Cesarean section scar is described. To the best of our knowledge, this is the first documented case of endomerioid carcinoma developing within the scar endometriosis in Korea.
Adenocarcinoma, Clear Cell/surgery ; Adenocarcinoma, Clear Cell/pathology ; Adenocarcinoma, Clear Cell/etiology* ; Carcinoma, Endometrioid/surgery ; Carcinoma, Endometrioid/pathology ; Carcinoma, Endometrioid/etiology* ; Case Report ; Cesarean Section/adverse effects* ; Cicatrix* ; Endometriosis/physiopathology ; Female ; Human ; Middle Age ; Tomography, X-Ray Computed/methods

A 60 year-old female complained with abdominal distension for one month. Stage IIIc, grade 2 clear cell carcinoma of the ovary was diagnosed after laparotomy. Weekly paclitaxel combined with carboplatin as adjuvant chemotherapy was given after optimal cytoreductive surgery. An acute cerebral infarction after first chemotherapy cycle was developed. The patient presented with dyspnoea after the third chemotherapy cycle and the symptom could be relieved at rest. Such symptom worsened and relieved alternatively for 3 days. A sudden dyspnoea occurred to the patient again when she got up one night, and died of respiratory and circulatory failure on the way to the hospital. Autopsy revealed ovarian clear cell carcinoma with metastasis to the whole pelvic and abdominal cavity and massive pulmonary arterial embolism (the length of embolus is 20 cm) with cerebral infarction. A conclusive remarks was made during the conference that patients who underwent operation and chemotherapy were at high risk for venous thrombosis (VT) and pulmonary embolism (PE). It was important to analyze a patient's individual risk for VT and PE. Appropriate thrombosis prophylaxis ought to be considered highly for high risk patients.
Adenocarcinoma, Clear Cell ; complications ; pathology ; Death, Sudden ; Female ; Humans ; Middle Aged ; Ovarian Neoplasms ; complications ; pathology ; Pulmonary Embolism ; etiology

Clear cell carcinoma (CCC) of the ovary is known to show poorer sensitivity to chemotherapeutic agents and to be associated with a worse prognosis than the more common serous adenocarcinoma or endometrioid adenocarcinoma. To improve the survival of patients with ovarian CCC, the deeper understanding of the mechanism of CCC carcinogenesis as well as the efforts to develop novel treatment strategies in the setting of both front-line treatment and salvage treatment for recurrent disease are needed. In this presentation, we first summarize the mechanism responsible for carcinogenesis. Then, we highlight the promising therapeutic targets in ovarian CCC and provide information on the novel agents which inhibit these molecular targets. Moreover, we discuss on the cytotoxic anti-cancer agents that can be best combined with targeted agents in the treatment of ovarian CCC.
Adenocarcinoma, Clear Cell/drug therapy/*etiology/metabolism ; Antineoplastic Agents/therapeutic use ; Female ; Forecasting ; Humans ; Neoplasm Recurrence, Local/prevention & control ; Ovarian Neoplasms/drug therapy/*etiology/metabolism

Adenocarcinoma, Clear Cell ; diagnosis ; etiology ; therapy ; Cervix Uteri ; pathology ; Child ; Diethylstilbestrol ; Fatal Outcome ; Female ; Humans ; Magnetic Resonance Imaging ; Pregnancy ; Prenatal Exposure Delayed Effects ; Uterine Cervical Neoplasms ; diagnosis ; etiology ; therapy

Adenocarcinoma, Clear Cell ; etiology ; pathology ; Brenner Tumor ; etiology ; pathology ; Carcinosarcoma ; etiology ; pathology ; Cell Transformation, Neoplastic ; Cystadenocarcinoma, Serous ; etiology ; pathology ; Epithelial Cells ; metabolism ; pathology ; Female ; Genes, p53 ; Humans ; Mutation ; Neoplasms, Glandular and Epithelial ; etiology ; genetics ; metabolism ; pathology ; Ovarian Neoplasms ; etiology ; genetics ; metabolism ; pathology ; Tumor Suppressor Protein p53 ; genetics ; metabolism