The Dichotomy in the Histogenesis of Endometriosis-associated Ovarian Cancer

Hirotaka Kajihara, Yoshihiko Yamada, Hiroshi Shigetomi, Yumi Higashiura, Hiroshi Kobayashi
In: International Journal of Gynecological Pathology · 2012 · vol. 31(4) , pp. 304–312 · doi:10.1097/pgp.0b013e318243a97b · W2328163964
article OA: closed CC0 ⤵ 15 in-corpus citations
Full text JSON View on OpenAlex View at publisher
⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-11 ⓘ

This study proposes that ovarian endometriosis and associated cancers originate from distinct cellular pathways involving either mesothelial–epithelial transition of cortical inclusion cysts or retrograde menstruation, with subsequent differentiation into endometrioid or clear cell carcinomas.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by qwen3.7-flash, 2026-08-29 · read from full text ⓘ

This study investigates the histogenesis of endometriosis-associated ovarian cancer by analyzing the cellular origins of clear cell and endometrioid adenocarcinomas through immunohistochemical markers. The authors propose that these distinct cancer types arise from separate precursors, with clear cell carcinoma originating from HNF-1β-positive epithelial cells derived from late secretory or menstrual endometria via retrograde menstruation. In contrast, endometrioid adenocarcinoma develops from HNF-1β-negative cells, potentially resulting from mesothelial-to-epithelial transition during cortical inclusion cyst formation. This paper is centrally about endometriosis — specifically examining the divergent histogenetic pathways leading to clear cell versus endometrioid-type ovarian cancers associated with the condition.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

The histogenesis of endometriosis and endometriosis-associated ovarian cancer is one of the most mysterious aspects of pathology. To better understand the histogenesis of endometriosis and endometriosis-associated ovarian cancer, we analyzed the possibility of a link of endometrium, ovarian surface epithelium, and a cortical inclusion cyst to ovarian endometriosis and endometriosis-associated ovarian cancer by immunohistochemistry using the epithelial membrane antigen (an epithelial marker), calretinin (a mesothelial marker), and hepatocyte nuclear factor (HNF)-1β (a clear cell carcinoma-specific transcription factor). During ovarian surface epithelium invagination, cortical inclusion cyst epithelial cells may, in some cases, undergo mesothelial–epithelial transition and subsequently differentiate into endometriosis. This case of endometriosis that has undergone Müllerian metaplasia arises from the HNF-1β-negative cells. The remaining endometriosis may develop from the late secretory and menstrual endometria, with HNF-1β-positive staining, by retrograde menstruation. Endometrioid adenocarcinoma and clear cell carcinoma arise from the HNF-1β-negative and HNF-1β-positive epithelial cells of endometriosis, respectively. It has been proposed that clear cell and endometrioid-type adenocarcinomas arise from distinct types of endometriosis with different cells of origin.
Full text 1,616 characters · extracted from oa-doi-fallback · click to expand
The Dichotomy in the Histogenesis of Endometriosis-associated Ovarian Cancer Clear Cell-type Versus Endometrioid-type Adenocarcinoma - Hirotaka Kajihara - Yoshihiko Yamada - Hiroshi Shigetomi - Yumi Higashiura - Hiroshi Kobayashi The histogenesis of endometriosis and endometriosis-associated ovarian cancer is one of the most mysterious aspects of pathology. To better understand the histogenesis of endometriosis and endometriosis-associated ovarian cancer, we analyzed the possibility of a link of endometrium, ovarian surface epithelium, and a cortical inclusion cyst to ovarian endometriosis and endometriosis-associated ovarian cancer by immunohistochemistry using the epithelial membrane antigen (an epithelial marker), calretinin (a mesothelial marker), and hepatocyte nuclear factor (HNF)-1β (a clear cell carcinoma-specific transcription factor). During ovarian surface epithelium invagination, cortical inclusion cyst epithelial cells may, in some cases, undergo mesothelial–epithelial transition and subsequently differentiate into endometriosis. This case of endometriosis that has undergone Müllerian metaplasia arises from the HNF-1β-negative cells. The remaining endometriosis may develop from the late secretory and menstrual endometria, with HNF-1β-positive staining, by retrograde menstruation. Endometrioid adenocarcinoma and clear cell carcinoma arise from the HNF-1β-negative and HNF-1β-positive epithelial cells of endometriosis, respectively. It has been proposed that clear cell and endometrioid-type adenocarcinomas arise from distinct types of endometriosis with different cells of origin.

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

⚙ Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback ⓘ

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

endometriosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (30)

Cited by (14)

Source provenance

openalex
last seen: 2026-06-10T17:14:06.276822+00:00
unpaywall
last seen: 2026-10-02T06:31:42.897446+00:00
License: CC0 · commercial use OK