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open access
Background
Malignant transformation of
endometriosis associated with episiotomy scar is a rare event,
especially histological type of clear cell adenocarcinoma. There are
only three clear cell carcinoma in episiotomy scar reported, no standard
treatment established.
Conclusions
We
report a case of clear cell carcinoma arising from episiotomy scar.
There are only three clear cell carcinoma in episiotomy scar reported,
no standard treatment established. Accumulation of management data on
these rare tumors and long-term follow-up of such patients is therefore
important.
Case presentation
A
36-year-old woman presented with a two-month history of painless but
puritic perineal lump which she noticed was gradually enlarging. The
patient’s past gynecological history included frequent vaginitis owing
to bad health habits and the lack of professional treatment. Because of
discomfort, the patient often scratched the vulva including the lesion
of the episiotomy scar for many years. In addition, her past obstetric
history was significant. She had a history of a forceps delivery
20 years ago. The postoperative recovery of perineal wound was slow.
Several months after delivery, she experienced cyclic perineal pain and
swelling of the episiotomy scar. Mifesterone and Medroxyprogesterone
acetate injectable suspension (DMPA) were used and the pain was
relieved. She had undergone surgical excision of a mass in the
episiotomy scar 9 year ago and resequently histological type of
endometriosis. DMPA was administrated for one year and then mifesterone
for half a year. Medical treatment with Chinese traditional medicine was
prescribed after that.....
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