EP22.07: A rare case of an abdominal wall clear cell carcinoma: an unusual presentation in a pelvic mass clinic

Abdominal wall clear cell carcinomas are rare and usually occur as a result of malignant transformation of endometriosis in a patient who has had gynecological or obstetric surgery. We present a case of a 57 year old woman who presented to the diagnostic ovarian two week wait clinic with a rapidly enlarging tender pelvic mass. She was para 2 with a Caesarean section 30 years previously and was not known to have any significant gynaecological history including endometriosis. A TA scan showed a 76mm irregular, solid, vascular mass seen within the abdominal wall below the umbilicus. A TVS confirmed a normal uterus and ovaries. The echogenicity and site of this mass were similar to abdominal wall endometriosis however due to the vascularity, irregular external contour and rapid growth the diagnosis of a metastatic mass was considered likely. After discussion with radiology the probability of a desmoid tumour was raised and the patient was referred for a CT scan and on to the sarcoma team. A biopsy diagnosed an adenocarcinoma of gynecological origin. The mass was excised with good margins by a combined gyneoncology/surgical team and a bilateral salpingo-oophrectomy also performed. No evidence of previous endometriosis seen at surgery. Histology confirmed the presence of metastatic adenocarcinoma with features of clear cell carcinoma FIGO stage 3. Normal ovarian histology. The patient declined chemotherapy and is currently well with no recurrence. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.