To investigate the occurrence of ovarian cancer (OC) arising in ovarian endometriosis (OE) diagnosed in our laboratory, and the relation of the disease to patient age.
Methods
Histopathological reports were reviewed in cases of endometriosis and ovarian cancer diagnosed between 1982 and 1989 and in 1997. The occurrence of OE and OC was studied in relation to patient age.
Results
Of the 796 OE cases, 36 (4.5%) ovarian cancers were found in the eight-year period, and of the 216 OC cases 36 (16.7%) were associated with OE; 12 patients (1.7%) were under 50 years old and 24 (22.9%) were over 50. In 1997 there were 168 cases of OE, and 4 cases were associated with OC. Of the 60 OC cases 4 cases arose in endometriosis. Two patients were over 50 and two under 50.
Conclusion
In our report the occurrence of OC arising in OE was most influenced by patient age, the extent of sampling and the consistency of histologic reports about the presence of endometriosis in ovarian adenocarcinoma.
endometriosis ovarian cancer association histopathological, ovarian endometriosis malignant transformation risk, endometriosis-associated ovarian cancer age relationship, ovarian cancer arising in endometriosis prevalence, Erzen Kovacic endometriosis ovarian cancer, endometriosis ovarian malignancy histologic sampling, ovarian endometriosis cancer risk patient age, endometrioid ovarian cancer endometriosis origin, endometriosis-related ovarian neoplasm retrospective review, ovarian cancer endometriosis coexistence pathology
Cite this article
Erzen, M., & Kovacic, J. (1998). Relationship between endometriosis and ovarian cancer. European journal of gynaecological oncology, 19(6), 553-555.
Erzen M, Kovacic J. Relationship between endometriosis and ovarian cancer. Eur J Gynaecol Oncol. 1998;19(6):553-555.
Erzen, Mojca, and J. Kovacic. "Relationship between endometriosis and ovarian cancer." European journal of gynaecological oncology, vol. 19, no. 6, 1998, pp. 553-555.
In 556 patients undergoing surgery for ovarian cancers the frequency of endometriosis ranged from 3.6% to 5.6% in serous, mucinous, and miscellaneous neoplasms versus 26.3%, 21.1%, and 22.2%, respectively, in endometrioid, clear cell, and mixed subtypes; the differences were statistically significant (chi 2 heterogeneity 50.0, p < 0.001) and consistent in strata of age, parity, menopausal status, and disease stage.
EndometriosisMalignant TransformationAssociation with Ovarian CancerEndometriosis-Related Carcinoma
To analyse the relationship between endometriosis and epithelial ovarian cancer. We analyzed retrospectively the 20 cases associated with endometriosis in 371 cases of epithelial ovarian cancer, and these 20 cases were also compared with the left 351 cases not associated with endometriosis(including endomtriod carcinoma 38 cases and clear cell carcinoma 39 cases). Among 20 cases, endomtriod carcinoma and clear cell carcinoma were most frequently associated with endometriosis, with 11 cases and 7 cases respectively, there was also 1 case of gland carcinoma and 1 case of serous papillary carcinoma. Cases of carcinomas associated with endometriosis had higher pathological grade and 5-year survival probability (Kaplan-Meier method) than those cases not associated with endometriosis. There is a close relationship between endometriosis and ovarian endomtriod carcinoma and clear cell carcinoma, the malignant transformation of endometriosis foci may be an important origin of them. Drug therapy is recommended for endomtriosis after the operation. In the treatment of endomtriod carcinoma and clear cell carcinoma, progestin can be used as an accessory method.
EndometriosisMalignant TransformationGenetic AlterationsOvarian Cancer
Endometriosis is a common gynecological disease in which tissue similar to the endometrium proliferates at sites outside the uterine cavity. Malignant transformation of endometriosis to endometrioid and clear cell ovarian carcinomas has been documented in histological studies, but no molecular genetic evidence exists to support that endometriosis is the clonal precursor of such malignancies. We examined 14 cases of endometriosis synchronous with ovarian cancer for loss of heterozygosity on 12 chromosome arms, X chromosome inactivation, and TP53 mutation to determine whether they shared genetic alterations. In all four of the cases where the carcinoma had arisen within endometriosis and in five of the seven cases where the carcinoma was adjacent to the endometriosis, common genetic lesions were detected, consistent with a common lineage. A TP53 mutation was also detected in one case of endometriosis adjacent to carcinoma. These findings support the numerous histological observations that endometrioid and clear cell ovarian carcinomas may arise through malignant transformation of endometriotic lesions.
EndometriosisMalignant TransformationOvarian Cancer in PregnancyOvarian Clear Cell Carcinoma
Sugiyama T et al., 1997·Eur J Obstet Gynecol Reprod Biol
We encountered a case of ovarian cancer in a 33-year-old, 8-week pregnant woman. Histological examination revealed both a transitive form of ovarian endometriosis with marked decidual changes due to pregnancy and clear cell carcinoma. Benign and borderline clear cell adenofibroma and benign and borderline endometrioid adenofibroma were also found. Parts of these adenofibromas showed transformation to clear cell carcinoma. This case suggests that clear cell carcinoma can arise from clear cell adenofibromas and/or ovarian endometriosis, even in young patients.