Clear cell ovarian carcinoma with endometriosis—A clinicopathologic analysis of 45 cases

Objective To study the clinicopathological features of clear cell ovarian carcinoma with endometriosis and other malignant epithelial tumors. Methods Primary lesions from 45 patients with clear cell ovarian carcinoma were reviewed. Correlation between pathological finding and clinical features was evaluated statistically.Results Abdominal pain, abdominal distention and pelvic mass were the most common findings (33 in 45, 73.3%). 20 patients were diagnosed as ovarian endometrioid cyst or endometriosis preoperatively (44.4%). According to the criteria suggested by FIGO, 26 cases were of stage I, 6 of stage II, 12 of stage III and 1 of stage IV. 28 cases were found with endometriosis (62.2%), 17 without (37.8%); in 26 cases of stage I, 19 with endometriosis and 7 without ( P 0.05). Of the 45 cases, 19 (42.22%) were simple clear cell ovarian carcinoma while 26 (57.78%) were mixed: 20 (76.9%) with endometrioid ovarian cystadenocarcinoma, 5 (13.2%) with serous cystadenocarcinoma and 1 (3%) with mucinous cystadenocarcinoma. Conclusion Most of the tumors of stage I were detected early because of presence of endometriosis, thus intensive follow up should be performed in those who are clinically diagnosed as endometrioid ovarian cyst or endometriosis. There is no difference in prognosis between the simple and the mixed clear cell ovarian carcinoma, and also between the clear cell ovarian carcinoma with or without endometriosis.