Clear cell carcinoma arising in endometriosis of the rectum following progestin therapy
Abstract
A 40-year-old woman presented at our hospital with rectal stenosis. Computed tomography demonstrated a conglomerate tumor in the pelvis and malignant look-alike lesions in the liver and in both lungs. A palliative deep rectum resection was done. Histologically, clear cell carcinoma with a small area of endometrioid carcinoma was diagnosed. Severe endometriosis had been diagnosed 13 years earlier. The patient had been treated with medroxyprogesterone acetate (MPA) for two years; no estrogen therapy had been given. The association between unopposed estrogen replacement therapy and malignant transformation of endometriosis is documented, but malignant transformation following progestin therapy has not been reported previously. It appears that radical surgery is the only means of preventing malignant transformation of the lesion in patients with endometriosis.
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Pokieser et al. considered that the short duration of MPA administration may not have contributed to the prevention of malignant transformation.
“They considered that the short duration of MPA administration may not have contributed to the prevention of malignant transformation [102].”
From Malignancies Associated with Extraovarian Endometriosis: A Literature Review (2021) · cites this paper as [102]
In that patient, clear cell carcinoma from endometriosis arose in the rectum later.
“However, clear cell carcinoma from endometriosis arose in the rectum later [102].”
From Malignancies Associated with Extraovarian Endometriosis: A Literature Review (2021) · cites this paper as [102]
Pokieser et al. reported a patient treated with MPA for 2 years who had a history of intra-abdominal hemorrhage due to rupture of ovarian endometriosis.
“In addition, Pokieser et al. reported a patient who was treated with MPA for 2 years and had a history of intra-abdominal hemorrhage due to rupture of ovarian endometriosis [102].”
From Malignancies Associated with Extraovarian Endometriosis: A Literature Review (2021) · cites this paper as [102]
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- Authors
- Pokieser, W., Schmerker, R., Kisser, M., Peters-Engl, C., Mühlbauer, H., & Ulrich, W.
- Affiliations
- Medical University of Vienna (AT)
- Corresponding author
- Pokieser, W.
- Venue
- Pathology - Research and Practice
- Publisher
- Elsevier BV
- Published
- 2002-01
- Volume
- 198
- Issue
- 2
- Pages
- 121-124
- ISSN
- 0344-0338 (ISSN-L)
- OpenAlex
- W2027034664
- Cited by
- 14
- References
- 16
- Citations by year
- 2025: 2 · 2024: 1 · 2022: 1 · 2021: 1 · 2014: 1 · 2012: 1
- FWCI
- 0.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pathology - Research and Practice (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Metastasis and carcinoma case studies
- Keywords
- clear cell carcinoma, endometriosis, rectal endometriosis, progestin therapy, medroxyprogesterone acetate, malignant transformation, endometrioid carcinoma, rectal stenosis
- MeSH terms
- Adult, Constriction, Pathologic, Endometriosis, Female, Humans, Periodic Acid-Schiff Reaction, Rectal Neoplasms, Rectum, Medroxyprogesterone Acetate, Fatal Outcome, Adenocarcinoma, Clear Cell, Progesterone Congeners
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