Postoperative management challenges in concurrent endometrioid carcinoma and PEComa a case report

Endometrioid carcinoma is one of the most prevalent malignant neoplasms in gynecology, in contrast to perivascular epithelioid cell tumor (PEComa), a rare stromal tumor, which is seldom encountered in the female genital system. The coexistence of endometrioid carcinoma and PEComa is exceedingly uncommon, presenting significant diagnostic and therapeutic challenges. This study aim to report a case of PEComa associated with endometrioid carcinoma and to deliberate on the complexities in diagnostic, treatment, and clinical implications. The patient was admitted to the hospital with a history of prolonged endometrial thickening and persistent vaginal bleeding. Following a laparoscopic total hysterectomy with bilateral salpingectomy and sentinel lymph node biopsy, the final diagnosis of endometrioid carcinoma with PEComa was determined through postoperative pathological analysis, revealing the PEComa’s potential for malignancy. The patient was not administered chemotherapy postoperative and, upon nine months of follow-up, demonstrated no-evidence recurrence or metastasis. The success of this case highlights the importance of an integrated diagnosis and treatment, emphasizing the necessity of a multidisciplinary approach in the management of rare, coexisting pathologies. Furthermore, this case provides valuable clinical insights and serves as a reference for future research focused on the diagnostic and therapeutic strategies for endometrioid carcinoma and PEComa.