Ovarian atypical endometriosis: its close association with malignant epithelial tumours
Abstract
The incidence of ovarian atypical endometriosis and its association with malignant epithelial tumours in a consecutive series of cases during the period 1987 to 1995 were studied. Atypical glandular changes were observed in four (1.7%) of 255 ovarian endometriosis cases and one patient with ovarian atypical endometriosis developed subsequent endometrioid carcinoma in the abdominal wall. Fifty-four (24.1%) of the 224 ovarian cancers were associated with ovarian endometriosis; 21 with typical and 33 with atypical endometriosis. Clear cell carcinomas and endometrioid carcinomas were most frequently associated with endometriosis, with 54% (27 of 50 cases) and 41.9% (13 of 31), respectively. Atypical endometriosis was found in 18 clear cell carcinomas, in seven endometrioid carcinomas, in four serous carcinomas, in three mucinous borderline tumours, and in one serous borderline tumour. In 13 cases, the atypical endometriosis was in contiguity with malignant epithelial tumours. We consider that atypical endometriosis possesses a precancerous potential or is most frequently associated with clear cell and endometrioid carcinomas. Close screening of cellular atypia or hyperplasia in ovarian endometriosis and careful long-term follow-up of patients with atypical endometriosis is required.
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14.7 to 22.8% of ovarian carcinomas coexist with atypical endometriosis.
“One of the reasons is that 14.7 to 22.8% of ovarian carcinomas coexist with atypical endometriosis [13,14].”
From Malignancies Associated with Extraovarian Endometriosis: A Literature Review (2021) · cites this paper as [13]
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“Unlike serous carcinomas, for which a precursor lesion has not been identified, clear cell carcinoma develops in a stepwise fashion proceeding from atypical endometriosis to an invasive carcinoma [8-11].”
BackgroundPathology of Endometrioid and Clear Cell Carcinoma of the Ovary
Fadare, O., & Parkash, V. (2019) · Surgical pathology clinics · doi:10.1016/j.path.2019.01.009 · Cited by 65 · see citing works
Unraveling the two entities of endometrioid ovarian cancer: A single center clinical experience
Mangili, G., Bergamini, A., Taccagni, G., Gentile, C., Panina‐Bordignon, P., Viganò, P., & Candiani, M. (2012) · Gynecologic Oncology · doi:10.1016/j.ygyno.2012.05.007 · Cited by 64 · see citing works
Gütgemann, I., Lehman, N. L., Jackson, P. K., & Longacre, T. A. (2008) · Modern Pathology · doi:10.1038/modpathol.3801022 · Cited by 64 · see citing works
Rahman, M. T., Nakayama, K., Rahman, M., Nakayama, N., Ishikawa, M., Katagiri, A., Iida, K., Nakayama, S., Otsuki, Y., Shih, I., et al. (2011) · Cancer · doi:10.1002/cncr.26598 · Cited by 62 · see citing works
Viganò, P., Somigliana, E., Parazzini, F., & Vercellini, P. (2007) · Fertility and Sterility · doi:10.1016/j.fertnstert.2006.11.180 · Cited by 62 · see citing works
Novel insights on the malignant transformation of endometriosis into ovarian carcinoma
Gadducci, A., Lanfredini, N., & Tana, R. (2014) · Gynecological Endocrinology · doi:10.3109/09513590.2014.926325 · Cited by 63 · see citing works
K-ras mutation may promote carcinogenesis of endometriosis leading to ovarian clear cell carcinoma
Otsuka, J., Okuda, T., Sekizawa, A., Amemiya, S., Saito, H., Okai, T., Kushima, M., & Tachikawa, T. (2004) · Medical Molecular Morphology · doi:10.1007/s00795-004-0252-5 · Cited by 60 · see citing works
“7% (4/225) of solitary ovarian endometriosis.(9) Theses findings suggest that ovarian atypical endometriosis may be a precancerous state of OEC and OCCA.”
BackgroundYamamoto, S., Tsuda, H., Yoshikawa, T., et al. (2007) · The American Journal of Surgical Pathology · doi:10.1097/01.pas.0000249449.13466.3c · Cited by 62 · see citing works
“In a large series of CCAs, the frequency of associated endometriosis was reported to be as high as 54%.(5) One clinical study has also noted that 88% of ovarian CCAs were preceded by an ultrasonographically detected endometriotic cyst.”
BackgroundEndometriosis-associated cancer
Guidozzi, F. (2021) · Climacteric · doi:10.1080/13697137.2021.1948994 · Cited by 60 · see citing works
BAF250a Expression in Atypical Endometriosis and Endometriosis-Associated Ovarian Cancer
Stamp, J. P., Gilks, C. B., Wesseling, M., Eshragh, S., Ceballos, K. M., Anglesio, M. S., Kwon, J. S., Tone, A. A., Huntsman, D. D., & Carey, M. S. (2016) · International Journal of Gynecological Cancer · doi:10.1097/igc.0000000000000698 · Cited by 59 · see citing works
“Though this rate is higher than reported in a literature review by Van Gorp et al(5) (36% CCC, 19% EC), it was similar to (42% EC, 54% CCC) the study reported by Fukunaga et al.(10) We found that the incidence of BAF250a loss by IHC in EaOC (55% in CCC and 33% in EC) was not remarkably different than our previous expe…”
BackgroundResultInfluentialEndometriosis as a model for inflammation–hormone interactions in ovarian and breast cancers
Ness, R. B., & Modugno, F. (2006) · European Journal of Cancer · doi:10.1016/j.ejca.2006.01.009 · Cited by 59 · see citing works
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Iron as a target of chemoprevention for longevity in humans
Toyokuni, S. (2011) · Free Radical Research · doi:10.3109/10715762.2011.564170 · Cited by 53 · see citing works
“7% of ordinary ovarian endometriosis [76].”
BackgroundFrozen Section Diagnosis of Ovarian Epithelial Tumors: Diagnostic Pearls and Pitfalls
Buza, N. (2018) · Archives of Pathology & Laboratory Medicine · doi:10.5858/arpa.2018-0289-ra · Cited by 52 · see citing works
Higashiura, Y., Kajihara, H., Shigetomi, H., & Kobayashi, H. (2012) · Oncology Letters · doi:10.3892/ol.2012.690 · Cited by 52 · see citing works
“Gene expression profiling studies suggest that SBT is genetically distinct from high-grade serous cancers (40).”
InfluentialThe Endometriotic Tumor Microenvironment in Ovarian Cancer
Wendel, J. R. H., Wang, X., & Hawkins, S. M. (2018) · Cancers · doi:10.3390/cancers10080261 · Cited by 51 · see citing works
Endometriosis-associated Ovarian Clear Cell Carcinoma: A Special Entity?
Sun, Y., & Liu, G. (2021) · Journal of Cancer · doi:10.7150/jca.61107 · Cited by 51 · see citing works
- Authors
- FUKUNAGA, M., NOMURA, K., ISHIKAWA, E., & USHIGOME, S.
- Affiliations
- Jikei University School of Medicine (JP)
- Corresponding author
- FUKUNAGA, M.
- ORCID
- FUKUNAGA, M.
- Venue
- Histopathology
- Publisher
- Wiley
- Published
- 1997-03
- Volume
- 30
- Issue
- 3
- Pages
- 249-255
- ISSN
- 0309-0167 (ISSN-L)
- 1365-2559
- OpenAlex
- W2084264037
- Cited by
- 333
- References
- 0
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 11 · 2023: 9 · 2022: 9 · 2021: 11 · 2020: 13 · 2019: 14 · 2018: 19 · 2017: 8 · 2016: 10 · 2015: 17 · 2014: 17 · 2013: 14 · 2012: 22
- FWCI
- 4.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Histopathology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Reproductive Medicine › Ovarian cancer diagnosis and treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
- Keywords
- endometrioma, endometrioid carcinoma, clear cell carcinoma, ovarian cancer, serous carcinoma, serous borderline tumor, long-term follow-up
- MeSH terms
- Adult, Carcinoma, Endometriosis, Female, Humans, Middle Aged, Ovarian Diseases, Ovarian Neoplasms
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