PMC4230015_01
(a) Smooth mass on the middle-left side of the cesarean median scar. (b) Pelvic MRI (T2 weighted image, axial section). MRI shows the tumor associated with cesarean section scar. The right side of the scar consists of solid components and the tumor at the left side of the scar is polycystic.
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Physical examination revealed a smooth mass measuring 4 cm in diameter on the middle-left side of the cesarean median scar (Figure 1(a)).
(a) In pathologic examination, many hobnail-shaped cells and clear cell were found. These are characteristic of clear cell adenocarcinoma (hematoxylin and eosin stain, magnification x100). (b) Pathologic examination showed clear cell adenocarcinoma and endometriosis. It suggests a malignant transformation from endometriosis of the abdominal wall (hematoxylin and eosin stain, magnification x100). (c) Staining estrogen receptor (ER), magnification x100.
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A biopsy of the mass showed atypical cells, and subsequent pelvic magnetic resonance imaging (MRI) showed two lesions, measuring 2.5 x 3.3 cm and 3.3 x 4.0 cm along the abdominal scar (Figure 2(b)). Histopathological examination showed clear cell adenocarcinoma (Figure 2(a)), suggesting malignant transformation from endometriosis of the abdominal wall.