OVARIAN ATYPICAL ENDOMETRIOSIS - ITS CLOSE ASSOCIATION WITH MALIGNANTEPITHELIAL TUMORS

The incidence of ovarian atypical endometriosis and its association wi th malignant epithelial tumours in a consecutive series of cases durin g the period 1987 to 1995 were studied. Atypical glandular changes wer e observed in four (1.7%) of 255 ovarian endometriosis cases and one p atient with ovarian atypical endometriosis developed subsequent endome trioid carcinoma in the abdominal wall. Fifty-four (24.1%) of the 224 ovarian cancers were associated with ovarian endometriosis; 21 with ty pical and 33 with atypical endometriosis. Clear cell carcinomas and en dometrioid carcinomas were most frequently associated with endometrios is, with 54% (27 of 50 cases) and 41.9% (13 of 31), respectively. Atyp ical endometriosis was found in 18 clear cell carcinomas, in seven end ometrioid carcinomas, in four serous carcinomas, in three mucinous bor derline rumours, and in one serous borderline tumour. In 13 cases, the atypical endometriosis was in contiguity with malignant epithelial ru mours. We consider that atypical endometriosis possesses a precancerou s potential or is most frequently associated with clear cell and endom etrioid carcinomas. Close screening of cellular atypia or hyperplasia in ovarian endometriosis and careful long-term follow-up of patients w ith atypical endometriosis is required.