Cancers associated with extraovarian endometriosis at less common/rare sites: A nationwide survey in Japan
Abstract
AIM: Endometriosis mostly affects the ovary but can also be present outside of the ovary including the pelvic peritoneum, intestine, urinary tract and lung. In case of ovarian endometriotic cyst, an increased risk of ovarian cancer, especially of clear cell and endometrioid histology, has been reported. However, because of the rarity, cancer occurrence from endometriosis at less common sites/rare sites is poorly understood. METHODS: We conducted a nationwide survey on the less common/rare site endometriosis in 3539 authorized facilities in Japan. We requested to complete a case report form for each case, including information on the history of endometriosis, treatment for endometriosis, type of surgery, involved site(s) of cancer and endometriosis, histology of cancer, chemotherapy and outcome. RESULTS: Out of 1397 confirmed cases of less common/rare site endometriosis, 11 cases of rare site endometriosis-associated cancer (RSEAC) were reported: seven of them were associated with intestinal endometriosis, three were associated with urinary tract endometriosis and one was associated with umbilical endometriosis. Interestingly, the histology was endometrioid in seven (64%) cases, and serous, seromucinous borderline, clear cell and mucinous in one case each (10%), differing from the case of ovarian endometriosis-associated cancer, in which clear cell carcinoma are more common. CONCLUSION: Our nationwide survey on RSEAC has revealed that: (i) the incidence of malignant transformation may be lower than ovarian endometriosis, (ii) malignant transformation from endometriosis outside the abdominal cavity may be extremely rare and (iii) the histology of RSEAC is predominantly endometrioid type, suggesting an association of a hormonal effect.
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Mandai et al. reported a nationwide study of cancer in patients with less common/rare site endometriosis; the coexistence rate of malignancy was 0.79% and was more rare compared to in the ovary.
“Mandai et al. reported a nationwide study of cancer in patients with less common/rare site endometriosis.The coexistence rate of malignancy was 0.79% and was more rare compared to in the ovary [20].”
From Malignancies Associated with Extraovarian Endometriosis: A Literature Review (2021) · cites this paper as [20]
The most common site in Mandai et al. was the intestine and the most common histological type was endometrioid carcinoma, which was different from those of ovarian origins.
“The most common site was the intestine and the most common histological type was endometrioid carcinoma, which was different from those of ovarian origins.”
From Malignancies Associated with Extraovarian Endometriosis: A Literature Review (2021) · cites this paper as [20]
Mandai et al. noted that the histologic type of the tumor might differ according to the site of origin.
“In addition, they noted that the histologic type of the tumor might differ according to the site of origin [20].”
From Malignancies Associated with Extraovarian Endometriosis: A Literature Review (2021) · cites this paper as [20]
Most extraovarian endometriosis, such as deep endometriosis and intestinal endometriosis, rarely forms large cysts, unlike in the ovary.
“As mentioned by Mandai et al., a factor may be that most extraovarian endometriosis, such as deep endometriosis and intestinal endometriosis, rarely form large cysts, unlike in the ovary [20].”
From Malignancies Associated with Extraovarian Endometriosis: A Literature Review (2021) · cites this paper as [20]
The rarity of large cyst formation in most extraovarian endometriosis may be a factor in the histological type distribution.
“As mentioned by Mandai et al., a factor may be that most extraovarian endometriosis, such as deep endometriosis and intestinal endometriosis, rarely form large cysts, unlike in the ovary [20].”
From Malignancies Associated with Extraovarian Endometriosis: A Literature Review (2021) · cites this paper as [20]
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Malignancies Associated with Extraovarian Endometriosis: A Literature Review
Inoue, N., Hirakawa, T., Mitsushita, J., Kitahara, Y., & Iwase, A. (2021) · Endocrines · doi:10.3390/endocrines2030024 · Cited by 7 · see citing works
“In addition, they noted that the histologic type of the tumor might differ according to the site of origin [20].”
BackgroundInfluential
- Authors
- Mandai, M., Osuga, Y., Hirata, T., Enomoto, T., Nakai, H., Honda, R., Taniguchi, F., & Katabuchi, H.
- Affiliations
- Kyoto University (JP)
- The University of Tokyo (JP)
- Niigata University (JP)
- Kindai University (JP)
- Kumamoto University (JP)
- Tottori University (JP)
- Corresponding author
- Mandai, Masaki
- ORCID
- Venue
- Journal of obstetrics and gynaecology research
- Publisher
- Wiley
- Published
- 2020-03-25
- Volume
- 46
- Issue
- 6
- Pages
- 917-923
- ISSN
- 1341-8076 (ISSN-L)
- 1447-0756
- OpenAlex
- W3013142600
- Cited by
- 14
- References
- 19
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 3 · 2022: 2 · 2021: 4
- FWCI
- 1.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of obstetrics and gynaecology research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Japan Society for the Promotion of Science (18K19600)
- 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
- intestinal endometriosis, urinary tract endometriosis, umbilical endometriosis, malignant transformation, endometrioid carcinoma, clear cell carcinoma, serous carcinoma, histology, endometriosis surgery
- MeSH terms
- Adult, Cell Transformation, Neoplastic, Endometriosis, Female, Humans, Japan, Middle Aged, Ovarian Neoplasms, Surveys and Questionnaires, Incidence, Endometrial Neoplasms, Adenocarcinoma, Clear Cell, Carcinoma, Endometrioid
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