Malignant Transformation of Endometriosis in the Ischioanal Fossa.

Jordan S Klebanoff,Mark G Cadungog,Shivani K Shah

doi:10.1155/2018/5643040

Jordan S Klebanoff, Mark G Cadungog + Show 1 more

Open Access

https://doi.org/10.1155/2018/5643040

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Abstract

We present the case of a 28-year-old nulliparous female with malignant transformation of an ectopic focus of endometriosis in the right ischioanal fossa. A 28-year-old nulliparous patient with a past medical history of polycystic ovarian syndrome (PCOS) was diagnosed with endometrioid adenocarcinoma in her right ischioanal fossa. Initially, patient presented to an emergency department and underwent a CT scan of the appendix to rule out appendicitis. A multiloculated cystic lesion adjacent to the right obturator internus muscle was found. She underwent surgical resection of the mass, which confirmed FIGO grade 2 endometrioid adenocarcinoma, followed by localized radiation therapy. Malignancy arising in endometriosis is rare, and the influence of PCOS on the rate of malignant transformation is not well established.

Highlights

We present a patient found to have endometrioid adenocarcinoma arising in a focus of extrapelvic endometriosis
The majority of identified endometrial malignancies that are believed to be related to polycystic ovarian syndrome (PCOS) are endometrioid adenocarcinomas [6]
The retrograde menstruation theory has been linked to local disease as well as distant intraabdominal spread and intrathoracic spread. None of these leading theories would explain an ectopic focus of endometriosis within the ischioanal fossa

Summary

Introduction

Endometriosis is a common clinical dilemma affecting up to 10% of reproductive aged women, with an even higher incidence in women with pelvic pain [1]. We present a patient found to have endometrioid adenocarcinoma arising in a focus of extrapelvic endometriosis. This is a 28-year-old nulliparous patient with a past medical history of polycystic ovarian syndrome (PCOS), anxiety, and depression with newly diagnosed endometrioid adenocarcinoma in her right ischioanal fossa.

Results

Conclusion