Ovarian endometriosis and clear cell carcinoma, leiomyomatosis peritonealis dissesminata, and endometrial adenocarcinoma: An unusual, pathogenetically related association
R. Guarch et al., Ovarian endometriosis and clear cell carcinoma, leiomyomatosis peritonealis dissesminata, and endometrial adenocarcinoma: An unusual, pathogenetically related association, INT J GYN P, 20(3), 2001, pp. 267-270
A 42 year-old female with a preoperative clinical diagnosis of ovarian canc
er underwent laparotomy which revealed leiomyomatosis peritonealis dissemin
ata (LPD) in the peritoneum and omentum and a left ovarian endometriotic cy
st associated with a clear cell carcinoma. A grade I, superficially invasiv
e villoglandular endometrial endometrioid adenocarcinoma was also found. Mi
croscopically, the endometriotic cyst wall contained an extensive periphera
l band-like condensation of stromal cells. These cells were strongly positi
ve for alpha inhibin and may have been the hormonal source responsible for
the induction of the simultaneous LPD and endometrial adenocarcinoma. It is
proposed that endometriosis is not only a precursor of clear cell carcinom
a but, through secondary hormonal induction of the surrounding ovarian stro
ma, may also provide a hormonal stimulus for diverse proliferative processe
s.