Postmenopozal ovarian endometrioma kaynaklı yüksek dereceli over seröz karsinomu: Nadir Görülen Bir Olgu

Esra Keleş, Canan Kabaca, Burak Giray
In: Sakarya Medical Journal · 2022 · doi:10.31832/smj.1035398 · W4293770679
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This case report describes a rare instance of high-grade serous ovarian carcinoma originating from an ovarian endometrioma in a postmenopausal woman presenting with pelvic pain and discharge.

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This paper is a case report describing a rarely encountered scenario in which a postmenopausal ovarian endometrioma developed into high-grade serous ovarian carcinoma. The authors present the clinical context and diagnostic findings typical of such a malignant transformation, framed as an unusual manifestation in a postmenopausal patient. Because it is a single case report with no comparative cohort, the major limitation is that it cannot establish incidence or causal mechanisms. This paper is centrally about endometriosis—specifically, malignant transformation of an ovarian endometrioma into high-grade serous carcinoma in a postmenopausal setting.

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Abstract

Epithelial ovarian serous cancer arising in endometrioma is an uncommon phenomenon. Here, we present a case of postmenopausal ovarian high-grade serous carcinoma associated with ovarian endometrioma. A 64-year-old woman attended the clinic with pelvic pain and persistent vaginal discharge. Ultrasonography revealed an endometrial thickness and 37*23 mm left cystic adnexal mass. During the operation, solid pelvic mass grossly located in the cul-de-sac infiltrating rectum and left ovarian cysts were observed. At the intraoperative frozen section, benign left adnexal mass, benign pelvic lymph nodes, and the morphological findings of adenocarcinoma with undetermined-site of the origin were detected in the uterus and rectosigmoid colon. Final pathology revealed a high-grade ovarian serous carcinoma arising in ovarian endometrioma from two microscopic focuses. In sum, when we encounter postmenopausal endometrioma with increased biomarkers, it is crucial to consider the possibility of malignant transformation to ovarian cancer.
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References

- 1. Del Carmen MG, Smith Sehdev AE, Fader AN, Zahurak ML, Richardson M, Fruehauf JP, et al. Endometriosis-associated ovarian carcinoma: differential expression of vascular endothelial growth factor and estrogen/progesterone receptors. Cancer. 2003;98:1658–1663. - 2. Kim HS, Kim TH, Chung HH, Song YS. Risk and prognosis of ovarian cancer in women with endometriosis: a meta-analysis. Br J Cancer. 2014;110(7):1878-1890. - 3. Sampson JA. Endometrial carcinoma of the ovary arising in endometrial tissue in that organ. Arch Surg. 1925;10:1–72. - 4. Heaps JM, Nieberg RK, Berek JS. Malignant neoplasms arising in endometriosis. Obstet Gynecol. 1990;75(6):1023–1028. - 5. Lim MC, Chun KC, Shin SJ, Lee IH, Lim KT, Cho CH, et al. Clinical presentation of endometrioid epithelial ovarian cancer with concurrent endometriosis: a multicenter retrospective study. Cancer Epidemiol Biomarkers Prev. 2010;19:398-404. - 6. Modesitt SC, Tortolero-Luna G, Robinson JB, Gershenson DM, Wolf JK. Ovarian and extraovarian endometriosis-associated cancer. Obstet Gynecol. 2002;100:788-795. - 7. Mangili G, Bergamini A, Taccagni G, Gentile C, Panina P, Viganò P, et al. Unraveling the two entities of endometrioid ovarian cancer: a single center clinical experience. Gynecol Oncol. 2012;126:403–407. - 8. Ulrich U, Rhiem K, Kaminski M, Wardelmann E, Trog D, Valter M, et al. Parametrial and rectovaginal adenocarcinoma arising from endometriosis. Int J Gynecol Cancer. 2005;15:1206–1209. Details Primary Language English Subjects Health Care Administration Journal Section Case Report Authors Esra Keles * 0000-0001-8099-8883 Türkiye Canan Kabaca 0000-0002-7069-279X Türkiye Burak Giray 0000-0002-3832-6634 Türkiye Publication Date September 29, 2022 Submission Date December 11, 2021 Acceptance Date August 18, 2022 Published in Issue Year 2022 Volume: 12 Number: 3

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endometrioma

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