{"paper_id":"3fa1b9b3-c2ac-475d-9a45-9d6fadaf71ec","body_text":"Abstract\nThe association between endometriosis and epithelial ovarian cancer has been supported by years of epidemiologic research. Approximately 1.0 % of women with endometriosis may undergo malignant transformation. The malignant transformation is believed to progress in a stepwise fashion through an intermediary endometriotic lesion, atypical endometriosis. The greatest risk is associated with epithelial ovarian cancer of endometrioid and clear cell histology. Endometriosis and ovarian cancer may share a common pathogenic mechanism: hyperestrogenism, excess oxidative stress, and inflammation derived from repeated hemorrhage and iron, contributing to ovarian tumorigenesis. The iron-induced signals can contribute to carcinogenesis via three processes: step 1, by increasing oxidative stress, which facilitates the accumulation of somatic mutations, contributing to endometriosis-associated ovarian cancer initiation; step 2, by creating an estrogen-dependent microenvironment, supporting endometrioid adenocarcinoma progression; and step 3, by surviving stressful periods, thereby contributing to clear cell carcinoma progression. In conclusion, some endometriosis lesions may predispose to ovarian cancer, but future studies are needed to know the exact mechanisms of endometriosis-associated ovarian cancer.\nAccess this chapter\nTax calculation will be finalised at checkout\nPurchases are for personal use only\nSimilar content being viewed by others\nReferences\nGiudice LC, Kao LC. Endometriosis. Lancet. 2004;364:1789–99.\nFigueira PG, Abrão MS, Krikun G, Taylor HS. Stem cells in endometrium and their role in the pathogenesis of endometriosis. 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Ovarian cancer in endometriosis: molecular biology, pathology, and clinical management. Int J Clin Oncol. 2009;14:383–91.\nAcknowledgments\nGrant support: Supported by Grant-in-Aid for Scientific Research from the Ministry of Education, Science, and Culture of Japan to the Department of Obstetrics and Gynecology, Nara Medical University (H. Kobayashi).\nConflict of Interest\nThe authors declare no conflict of interest.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEditor information\nEditors and Affiliations\nRights and permissions\nCopyright information\n© 2014 Springer Japan\nAbout this chapter\nCite this chapter\nKobayashi, H. (2014). Malignant Transformation of Endometriosis. In: Harada, T. (eds) Endometriosis. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54421-0_29\nDownload citation\nDOI: https://doi.org/10.1007/978-4-431-54421-0_29\nPublished:\nPublisher Name: Springer, Tokyo\nPrint ISBN: 978-4-431-54420-3\nOnline ISBN: 978-4-431-54421-0\neBook Packages: MedicineMedicine (R0)","source_license":"CC0","license_restricted":false}