Endometrioid adenocarcinoma 13 years after total abdominal hysterectomy and bilateral salpingo-oophorectomy.

Ayman Al-Talib, Ayman Al‐Talib, Lucy Gilbert, Jocelyne Arseneau
Saudi medical journal · 2008 · vol. 29(7) , pp. 1044–1047 · doi:10.15537/1658-3175.4404 · PMID:18626539 · W2122089510
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

This case report describes a patient who developed metastatic endometrioid adenocarcinoma 13 years after hysterectomy and oophorectomy for endometriosis, highlighting the potential for malignant transformation in residual endometriosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 · read from full text ⓘ

This case report describes a 68-year-old woman with a history of endometriosis who underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy, after which she received estrogen-only replacement therapy. Thirteen years later she presented with a left pelvic mass and shortness of breath; imaging showed pleural effusion and a pelvic soft tissue mass, and biopsy with immunohistochemistry supported metastatic endometrioid adenocarcinoma. The authors report treatment with six cycles of carboplatin and paclitaxel with a good response. As a single-patient case report, it cannot establish causality, and the paper explicitly raises unopposed estrogen exposure as a possible mechanism of malignant transformation in residual endometriosis. This paper is centrally about endometriosis — it reports endometrioid adenocarcinoma occurring many years after surgery for endometriosis, with discussion of estrogen-only replacement as a contributing factor.

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Abstract

Malignant transformation is an infrequent complication of endometriosis. As endometriosis is an ectopic endometrium, hyperestrogenism may cause hyperplasia or transformation into cancer. We describe a case of a 68-year-old woman who underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometriosis. She was subsequently placed on estrogen-only replacement therapy. She presented with left-sided pelvic mass and shortness of breath. Computed tomography of chest, pelvis, and abdomen, demonstrated right-sided pleural effusion and soft tissue mass in the pelvis. Pleural effusion was tapped and biopsy from the peritoneal mass showed metastatic adenocarcinoma; immunohistochemistry findings favored endometrioid adenocarcinoma. She was treated by 6 cycles of Carboplatin/Paclitaxel and responded well. Unopposed estrogen stimulation may lead to premalignant or malignant transformation in the residual foci of endometriosis. Therefore, the addition of progestins to estrogen replacement therapy should be considered in women who have undergone hysterectomy with oophorectomy due to endometriosis.
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Abstract ABSTRACT Malignant transformation is an infrequent complication of endometriosis. As endometriosis is an ectopic endometrium, hyperestrogenism may cause hyperplasia or transformation into cancer. We describe a case of a 68-year-old woman who underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometriosis. She was subsequently placed on estrogen-only replacement therapy. She presented with left-sided pelvic mass and shortness of breath. Computed tomography of chest, pelvis, and abdomen, demonstrated right-sided pleural effusion and soft tissue mass in the pelvis. Pleural effusion was tapped and biopsy from the peritoneal mass showed metastatic adenocarcinoma; immunohistochemistry findings favored endometrioid adenocarcinoma. She was treated by 6 cycles of Carboplatin/Paclitaxel and responded well. Unopposed estrogen stimulation may lead to premalignant or malignant transformation in the residual foci of endometriosis. Therefore, the addition of progestins to estrogen replacement therapy should be considered in women who have undergone hysterectomy with oophorectomy due to endometriosis. Article Type Case Report First Page 1044 Last Page 1047 Recommended Citation Al-Talib, Ayman; Gilbert, Lucy; and Arseneau, Jocelyne (2008) "Endometrioid adenocarcinoma 13 years after total abdominal hysterectomy and bilateral salpingo-oophorectomy.," Saudi Medical Journal: Vol. 29: Iss. 7, Article 23. DOI: https://doi.org/10.15537/1658-3175.4404

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Carcinoma, Endometrioid Endometriosis Peritoneal Neoplasms Aged Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Endometriosis Endometriosis Endometriosis Estrogen Replacement Therapy Fallopian Tubes Fallopian Tubes Female Humans Hysterectomy Ovariectomy Peritoneal Neoplasms Peritoneal Neoplasms Peritoneal Neoplasms

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