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

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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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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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