Rs. Delacuesta et al., HISTOLOGIC TRANSFORMATION OF BENIGN ENDOMETRIOSIS TO EARLY EPITHELIALOVARIAN-CANCER, Gynecologic oncology, 60(2), 1996, pp. 238-244
Between 1975 and 1990, 79 patients with Stage I epithelial ovarian can
cer were treated at Massachusetts General Hospital. Patients were iden
tified from the tumor registry and medical records were retrospectivel
y reviewed. Pathological slides were evaluated for the presence of end
ometriosis, specifically looking for malignancy arising in endometrios
is. Evidence of endometriosis was found in 22 of the 79 cases (28%). I
n the 23 cases of endometrioid histology, 9 cases (39%) were associate
d with endometriosis and, in the 17 cases of clear cell tumors, 7 (41%
) were associated with endometriosis. All 8 cases of mixed histology h
ad clear cell and/or endometrioid components and 4 cases (50%) were as
sociated with endometriosis. Endometrioid adenocarcinoma accounted for
41% of the tumors associated with endometriosis, clear cell carcinoma
31%, mixed (endometrioid and/or clear cell types) 18%, and other type
s 9%. Among the 22 patients with associated endometriosis, we found 7
carcinomas (32%) arising in endometriosis. In these 7 cases a spectrum
of benign and atypical endometriosis with a transition to clear cell
or endometrioid adenocarcinoma were identified. These premalignant cha
nges were characterized by cytologic atypia and architectural prolifer
ation. Endometriosis was frequently encountered among patients with St
age I epithelial ovarian cancer of endometrioid and clear cell histolo
gies. Endometriosis may play a role in the pathogenesis of some early
stage malignant ovarian epithelial neoplasms. (C) 1996 Academic Press,
Inc.