MALIGNANCY ARISING IN EXTRAOVARIAN ENDOMETRIOSIS DURING ESTROGEN STIMULATION

Objective: Endometriosis can undergo estrogen-dependent changes simila r to endometrium and may carry a risk of developing hyperplasia and ca rcinoma during unopposed estrogen stimulation. Material-Method: We rev iewed the existing literature to analyze the potential of a malignancy arising from extraovarian endometriosis by estrogen stimulation. Resu lts: To our knowledge, there are 20 published cases so far, with a mal ign transformed endometriosis during estrogen stimulation at an extrao varian site. The most common site of malignancy arising from endometri osis was the vagina (n=5). The most common histological finding was ad enocarcinoma (n=13). The incidence of malignant transformation in extr aovarian endometriosis during unopposed estrogen replacement can not b e estimated based upon these case reports. Conclusion: Unopposed estro gen stimulation may lead to premalignant or malignant transformation i n the residual foci of endometriosis. Therefore, the addition of proge stins to estrogen replacement therapy should be considered in women wh o have undergone hysterectomy with oophorectomy because of endometrios is, especially if they are known to have residual endometriosis.