Background: Primary clear cell adenocarcinoma of the abdominal wall is exceptionally rare and most likely arises within scar endometriosis.
Case: A 37-year-old woman with 3 prior cesarean sections developed an abdominal wall mass that was confirmed as clear cell adenocarcinoma.
Conclusion: Clear cell adenocarcinoma is in the differential diagnosis of abdominal wall masses, particularly in cases of prior surgery. Fine needle aspiration may be helpful in establishing the diagnosis.