Malignant Transformation Associated with Endometrioid Adenocarcinoma of Abdominal Wall Endometriosis: A Case Report and Literature Review.

Introduction: Endometriosis is a prevalent chronic gynecological disease, characterized by the growth of endometrial glands and stroma outside the uterus and by the presence of chronic inflammatory lesions. This condition is one of the most common benign endometrioid proliferations, especially among premenopausal women. Although it is considered benign, endometriosis shares biological characteristics with malignant tumors, including invasion, implantation, metastasis, and recurrence. Abdominal wall endometriosis (AWE) refers to the presence of endometriosis lesions within the abdominal wall, with an extremely low incidence. Malignant transformation of AWE is exceptionally rare. Case Presentation: A 39-year-old female was admitted to the hospital on May 11, 2023, due to progressive enlargement of an abdominal mass noticed over a period of 4 months. To our knowledge, malignant transformation of abdominal wall endometriosis (AWE) is extremely rare in clinical practice, and cases of endometrioid adenocarcinoma arising from cesarean section-related AWE are even more scarce. Her medical history included surgery for a left lung teratoma 20 years ago and a cesarean section 6 years ago, with no family history of malignant tumor. This report presents a case of AWE subsequent to cesarean section, demonstrating a rare occurrence of malignant transformation into endometrioid adenocarcinoma. Conclusion: This article emphasizes the need for heightened vigilance regarding the possibility of malignant transformation in AWE patients and suggests a multidisciplinary team (MDT) approach and individualized treatment to improve clinical outcomes. A summary of the malignant transformation associated with endometrioid adenocarcinoma in cases of AWE has been provided to describe the Pathogenesis, Clinical Manifestation, Auxiliary Examination, Pathological Features, Treatment and Follow-up of this rare condition.