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Clear Cell Adenocarcinoma Arising in Endometriosis of a Previous Episiotomy Site

Kwon, Yong-Soon1; Nam, Joo-Hyun MD1; Choi, Gawon2

doi: 10.1097/AOG.0b013e318179475b
Case Reports

BACKGROUND: Malignant transformation of endometriosis in an episiotomy site is rare.

CASE: A 42-year-old woman presented with a palpable mass, 2.5 cm in size, just inside the posterior commissure of the vagina, at the site of a previous episiotomy for a vaginal delivery. Three years previously, an endometriotic cyst had been excised at the same site, and the patient had been treated with a gonadotropin-releasing hormone analogue for 6 months. Biopsy revealed a clear cell adenocarcinoma arising in endometriosis. The patient underwent radical surgery alone without adjuvant therapy. At 10-month follow-up, there was no evidence of recurrence.

CONCLUSION: Patients who experience a recurrence of extragonadal endometriosis after prior therapy should be monitored carefully for malignant degeneration.

A clear cell carcinoma arose in endometriosis of a previous episiotomy site.

From the 1Department of Obstetrics and Gynecology and the 2Department of Pathology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.

Corresponding author: Joo-Hyun Nam, 138-736 Pungnap-2-dong 388-1 Songpa-gu, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea; e-mail:

Financial Disclosure The authors have no potential conflicts of interest to disclose.

© 2008 The American College of Obstetricians and Gynecologists