Development of clear cell carcinoma based on iatrogenic endometriosis - case series.

Abstract

Iatrogenic endometriosis, a rare form of endometriosis resulting from surgical interventions, has become increasingly recognized as a complication of cesarean sections. This study examines the development of clear cell carcinoma (CCC) arising from endometrial tissue implanted in cesarean section scars. Based on a review of 41 clinical cases, the study highlights the challenge in diagnosis and management of this uncommon aggressive malignancy. The average delay from cesarean section to diagnosis was 18 years, with common symptoms being painful masses and scar tenderness. Imaging modalities such as magnetic resonance imaging (MRI) and computed tomography (CT) were the first diagnostic tools, while biopsy confirmed malignancy in most cases. The outlook for patients who had CCC in cesarean scars was extremely poor, and scant long-term survival data existed. These observations serve to reemphasize the necessity of increased awareness by gynecologists and obstetricians of the risk potential associated with cesarean delivery. Improved diagnostic scrutiny, especially in the patient who comes to the doctor with unexplained symptoms involving the scar, is recommended in this study. A strong role is also supported in informed choice before surgical modes of delivery are attempted.