{"paper_id":"a6785ccd-94e7-4a35-a839-d4ea4e96d900","body_text":"73\nContext\nEndometrioid borderline tumor (EBT), also known as atypical \nproliferative endometrioid tumor, accounts for 0.2% of ovarian \nneoplasmas and 2-3% of borderline ovarian tumors. Very little is \nknown about the prognosis and management of this entity. It is \nimportant to correctly diagnose these rare tumors in young women \nto assure proper treatment and to prevent mortality and preserve \nfertility.\nObjective\nWe report a case of EBT with endometriosis in a 26-year-old \nwoman. \nCase Report\nA 26-year-old female patient diagnosed with a left ovarian mass \nwas referred to our institution for elective surgery. The patient \npresented with chronic pelvic pain (pain score 60-70 mm on a \n100-mm visual analog scale) and dysmenorrhea since menarche \nat the age of 14 years, requiring the intake of nonsteroidal anti-\ninflammatory drugs and leading to asthenia. Ovarian mass was  \n \nfound 3 years earlier by ultrasonography. An analgesic therapy was \nprescribed. Gravida 1 and parity 0. Planning on getting pregnancy. \nShe had family history of endometriosis and not oncological family \nhistory. On gynecological examination there was a palpable pelvic \nfirm mass of about 10 cm in size in the left iliac region, solid-elastic \ntexture with tenderness and displacement of the uterus to the right.\nUltrasonography demonstrated a left ovarian cystic mass \n(12.0x8.7cm) with hyper-attenuated solid portions, thickened and \nwith single loci of blood flow at CDI. The level of tumor markers \nHE4(63.72 pmol/L), CA 125(35.6U/mL), ROMA scores (23.97%) \nindicated a high malignant ovarian lesions risk in premenopausal \nwomen. On workup there was not revealed a prevalence of tumor.\nOn laparoscopic surgical exploration the findings were \nleft ovarian with adhesions, presented cystic mass measuring \n11.5x10.0cm; uterosacral ligaments and broad ligaments of the \nuterus with multiple endometriotic nodules from 0.5 to 1.2cm. \nLaparoscopic left ovarian cystectomy, excision and ablation of \nendometriotic nodules, endometrial biopsy was performed. \nPostoperative was uncomplicated.\nAnna Protasova1*, Anna Tsypurdeeva1,2, Grigory Raskin1,3 and Nurana Bairamova1\n1Department of Medicine, St. Petersburg University, St. Petersburg, Russia \n2Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia \n3Department of Pathology, Russian Scientific Center for Radiology and Surgical Technologies, St. Petersburg, Russia\n*Corresponding author: Anna Protasova, Department of Medicine, St. Petersburg University, St. Petersburg, Russia\nSubmission: \n  January 13, 2017; Published: \n  January 23, 2018  \nEndometrioid Borderline Tumor Related to \nOvarian Endometriosis\nCase Report                                          \nCopyright © All rights are reserved by Anna Protasova.\nCRIMSONpublishers\nhttp://www.crimsonpublishers.com\nResult\n                  (a)                                              (b)                                                 (c)                                             (d)\nFigure 1: Endometrioid borderline tumor, H&E sections, 20x EE (a); expression of ER, 20x EE (b); Ki-67, 20x EE (c); BAF250a, \n40x EE (d).\nISSN: 2577-2015\n\nHow to cite this article: Anna P, Anna T, Grigory R, Nurana B. Endometrioid Borderline Tumor Related to Ovarian Endometriosis. Gynecol Res Women’s Health. \n1(4). IGRWH.000520: 2018. DOI: 10.31031/IGRWH.2018.01.000520\n74\nInvest Gynecol Res Women’s HealthInvestigations in Gynecology Research & Womens Health\nPathological findings presented both EBT with no invasion \nand endometriosis within this ovarian tumor. Microscopically, low \npapillary lesions with squamous morules were detected as well as \nfocal atrophic glandular linings with polymorphic cells. Nuclear \nstratification was noted, but no invasive growth was apparent. \nTypical endometriosis lesions were present. Immunohistochemical \nstudies demonstrated positive for estrogen receptor (ER), \nprogesterone receptor (PR), Epithelial Membrane Antigen (EMA), \nnegative for p53, alpha-inhibin, Wilms tumor gene (WT1). Ki-\n67 labeling index was 8%. Loss BAF250a (encoded by ARID1A) \nexpression in EBT and endometriotic tissue did not observe \n(Figures 1a-1d).\nFinal diagnosis was ovarian endometrioid borderline tumor \nstage IA.\nThe patient had been taking Dienogest 2mg once daily \ntreatment. The follow-up every three months within 36 months \nshowed no evidence of disease recurrence. To date, this woman \naged 29 years has a regular menstruation, no pelvic pain and does \nnot plan a pregnancy in near future.\nConclusion\nTherefore, this report implies association between \nendometriosis and EBT . Histological and IHC establish a diagnosis \nEBT and optimize surgical treatment in reproductive aged women, \nas well as preserve fertility.","source_license":"CC0","license_restricted":false}