Ovarian Endometriosis Associated with Ovarian Carcinoma: A Clinicopathological and Immunohistochemical Study

S Ogawa, Shinji Ogawa, Ogawa S, Kaku T, Tsunehisa Kaku, T Kaku, Amada S, S Amada, Satoshi Amada, Hiroaki Kobayashi, Kobayashi H, H. Kobayashi, T Hirakawa, Toshio Hirakawa, Hirakawa T, K Ariyoshi, Ariyoshi K, Kazuya Ariyoshi, Kamura T, T Kamura, Toshiharu Kamura, Nakano H, Hitoo Nakano, H Nakano
Gynecologic Oncology · 2000 · vol. 77(2) , pp. 298–304 · doi:10.1006/gyno.2000.5765 · PMID:10785482 · W2018077886
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This study investigated the clinicopathological and immunohistochemical features of ovarian endometriosis when it is associated with ovarian carcinoma.

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Abstract

ObjectiveThe purpose of this study was to demonstrate the incidence, the histopathological characteristics, and the proliferation activity of endometriosis and atypical endometriosis associated with ovarian carcinoma.MethodsMicroscopic slides of primary lesions from 127 patients with primary ovarian carcinoma were reviewed. The presence or absence of endometriosis and the transitions from typical endometriosis to atypical endometriosis and from atypical endometriosis to carcinoma were also histologically evaluated. Ki-67 immunoreactivity of typical and atypical endometriosis and carcinoma was examined. In addition, endometrial metaplasias were also evaluated.ResultsOf the 127 patients, 37 had endometriosis: 70% (30/43) had clear cell adenocarcinoma, 43% (3/7) had endometrioid adenocarcinoma, 7% (4/60) had serous adenocarcinoma, and none (0/17) had mucinous adenocarcinoma. Thirty-three cases showed typical endometriosis and 29 cases had atypical endometriosis (25 cases had both). Tufting and the stratification of the lining epithelium were observed in 25 and 23 cases, respectively. The transition from typical endometriosis to atypical endometriosis was observed in 22 cases, and the transition from atypical endometriosis to carcinoma, in 23 cases. Only one case showed a direct transition from typical endometriosis to carcinoma. The mean Ki-67 indices were as follows: ovarian carcinoma, 23.1; atypical endometriosis, 9.9; typical endometriosis, 2.7. In 18 cases with metaplasia in endometriosis, eosinophilic metaplasia and ciliated metaplasia were the most common types. Five cases had two types of metaplasia.ConclusionsOvarian carcinomas, especially clear cell and endometrioid adenocarcinomas, are highly associated with endometriosis. Atypical endometriosis shows proliferation activity intermediate to those of typical endometriosis and ovarian carcinoma, suggesting it is a precancerous status.

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Condition tags

endometriosis

MeSH descriptors

Adenocarcinoma, Clear Cell Cystadenoma, Serous Endometriosis Ovarian Diseases Ovarian Neoplasms Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adult Aged Aged, 80 and over Cell Division Cystadenoma, Serous Cystadenoma, Serous Endometriosis Endometriosis Endometriosis Female Humans Immunohistochemistry Ki-67 Antigen

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