Ovarian Endometriosis and Clear Cell Carcinoma, Leiomyomatosis Peritonealis Disseminata, and Endometrial Adenocarcinoma: An Unusual, Pathogenetically Related Association

Guarch R, Rosa Guarch, R Guarch, A Puras, Puras A, R Ceres, Ceres R, María Alejandra Isaac, Isaac MA, M A Isaac, Nogales FF, F F Nogales, Francisco F. Nogales
International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists · 2001 · vol. 20(3) , pp. 267–270 · doi:10.1097/00004347-200107000-00010 · PMID:11444203 · W2065409196
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This case report describes an unusual association between ovarian endometriosis, clear cell carcinoma, leiomyomatosis peritonealis disseminata, and endometrial adenocarcinoma in a 42-year-old female.

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This case report describes a 42-year-old woman diagnosed with ovarian clear cell carcinoma, leiomyomatosis peritonealis disseminata, and endometrial adenocarcinoma. Microscopic analysis revealed an extensive band of stromal cells within the endometriotic cyst wall that were strongly positive for alpha inhibin, suggesting these cells acted as a hormonal source. The authors propose that endometriosis may serve not only as a precursor to clear cell carcinoma but also as a stimulus for other proliferative processes through secondary hormonal induction of surrounding ovarian stroma. This paper is centrally about endometriosis — specifically its role as a pathogenetic link between clear cell carcinoma, leiomyomatosis peritonealis disseminata, and endometrial adenocarcinoma via hormonal mechanisms.

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Abstract

A 42 year-old female with a preoperative clinical diagnosis of ovarian cancer underwent laparotomy which revealed leiomyomatosis peritonealis disseminata (LPD) in the peritoneum and omentum and a left ovarian endometriotic cyst associated with a clear cell carcinoma. A grade 1, superfically invasive villoglandular endometrial endometrioid adenocarcinoma was also found. Microscopically, the endometriotic cyst wall contained an extensive peripheral band-like condensation of stromal cells. These cells were strongly positive 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 carcinoma but, through secondary hormonal induction of the surrounding ovarian stroma, may also provide a hormonal stimulus for diverse proliferative processes.
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Ovarian Endometriosis and Clear Cell Carcinoma, Leiomyomatosis Peritonealis Disseminata, and Endometrial Adenocarcinoma: An Unusual, Pathogenetically Related Association - Rosa Guarch - Ana Puras - Rafael Ceres - M. Alejandra Isaac - Francisco F. Nogales Summary: A 42 year-old female with a preoperative clinical diagnosis of ovarian cancer underwent laparotomy which revealed leiomyomatosis peritonealis disseminata (LPD) in the peritoneum and omentum and a left ovarian endometriotic cyst associated with a clear cell carcinoma. A grade 1, superficially invasive villoglandular endometrial endometrioid adenocarcinoma was also found. Microscopically, the endometriotic cyst wall contained an extensive peripheral band-like condensation of stromal cells. These cells were strongly positive 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 carcinoma but, through secondary hormonal induction of the surrounding ovarian stroma, may also provide a hormonal stimulus for diverse proliferative processes.

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Condition tags

endometriosis

MeSH descriptors

Adenocarcinoma Adenocarcinoma, Clear Cell Endometrial Neoplasms Endometriosis Leiomyomatosis Neoplasms, Hormone-Dependent Neoplasms, Multiple Primary Ovarian Neoplasms Peritoneal Neoplasms Adenocarcinoma Adenocarcinoma Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adult Endometrial Neoplasms Endometrial Neoplasms Endometriosis Endometriosis Female Humans

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References (17)

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