DEGENERAÇÃO MALIGNA DA ENDOMETRIOSE: REVISÃO DA LITERATURA

Elisa Simionato Alban, Thábata Machado Scridelli Mounzer, Carla Vanin, Andressa Biscaro
In: Arquivos Catarinenses de Medicina · 2017 · vol. 46(2) , pp. 145–152 · doi:10.63845/xf9qww04 · W2743200492
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This literature review evaluates the etiology and potential causes of malignant transformation in endometriosis, noting its association with increased ovarian cancer risk and the diagnostic potential of MRI.

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This literature review examines malignant transformation of endometriosis, estimating that it occurs in 0.3–1% of endometriosis cases, with 75% occurring in the ovaries. It surveys proposed etiologic contributors including hormonal influences, inflammation, familial predisposition, immunologic alterations, oxidative stress, and environmental factors, and reports that endometriosis patients have an increased ovarian cancer risk ranging from 1.3 to 1.9, up to 2.7 when endometriosis is associated with infertility. The review states that no diagnostic tools currently identify women at highest risk and that nuclear magnetic resonance is considered the most promising diagnostic instrument for assessing malignant transformation. This paper is centrally about endometriosis — it focuses specifically on malignant degeneration/transformação maligna arising in endometriosis.

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Abstract

Estima-se que ocorra transformação maligna em 0,3 a 1% dos casos de endometriose, sendo 75% nos ovários. Fatores hormonais, inflamação, predisposição familiar, alterações imunológicas, estresse oxidativo e fatores ambientais são apontados como possíveis fatores de carcinogênese. Estudos demonstram que pacientes com endometriose apresentam aumento do risco de câncer de ovário que pode variar de 1,3 a 1,9, podendo chegar a 2,7 naquelas com endometriose associada à infertilidade. Até o momento não existem ferramentas diagnósticas capazes de identificar quais mulheres estão sob maior risco e o instrumento diagnóstico mais promissor para avaliar a transformação maligna da endometriose parece ser a ressonância nuclear magnética. Esta revisão tem como objetivo avaliar a etiologia e possíveis causas da transformação maligna da endometriose através da realização de uma revisão da literatura.
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DEGENERAÇÃO MALIGNA DA ENDOMETRIOSE: REVISÃO DA LITERATURA DOI: https://doi.org/10.63845/xf9qww04Palavras-chave: Endometriose. Transformação maligna. Câncer de ovário.Resumo Estima-se que ocorra transformação maligna em 0,3 a 1% dos casos de endometriose, sendo 75% nos ovários. Fatores hormonais, inflamação, predisposição familiar, alterações imunológicas, estresse oxidativo e fatores ambientais são apontados como possíveis fatores de carcinogênese. Estudos demonstram que pacientes com endometriose apresentam aumento do risco de câncer de ovário que pode variar de 1,3 a 1,9, podendo chegar a 2,7 naquelas com endometriose associada à infertilidade. Até o momento não existem ferramentas diagnósticas capazes de identificar quais mulheres estão sob maior risco e o instrumento diagnóstico mais promissor para avaliar a transformação maligna da endometriose parece ser a ressonância nuclear magnética. Esta revisão tem como objetivo avaliar a etiologia e possíveis causas da transformação maligna da endometriose através da realização de uma revisão da literatura.Referências Sampson JA. Endometrial carcinoma of the ovary arising in endometrial tissue in that organ. Am J Obstet Gynecol.1925;9(1):111–4. DOI: https://doi.org/10.1016/S0002-9378(25)90949-0 Scott RB. Malignant changes in endometriosis. Obstetrics and Gynecology. 1953; 2(3):283–9. Worley Jr MJ, Welch WR, Berkowitz RS, Ng SW. Endometriosis-Associated Ovarian Cancer: A Review of Pathogenesis. Int. J. Mol. Sci. 2013;14:5367-79. DOI: https://doi.org/10.3390/ijms14035367 Zafrakas M, Grimbizis G, Timologou A, Tarlatzis BC. Endometriosis and ovarian cancer risk: a systematic review of epidemiological studies. Gynecology and Obstetrics 2014;1(14):1-6. DOI: https://doi.org/10.3389/fsurg.2014.00014 Garcia-Marin JA, Pellicer-Franco EM, Soria-Aledo V, Mengual-Ballester M, Valero-Navarro G, Aguayo-Albasini JL. Malignant degeneration of rectal endometriosis. Rev Esp Enferm Dig 2015;107(12):761-4. DOI: https://doi.org/10.17235/reed.2015.3648/2014 Nezhat F, Apostol R, Mahmoud M, Daouk M. Fertility and Sterility 2014;102(2): 342-4. DOI: https://doi.org/10.1016/j.fertnstert.2014.04.050 Verit FF, Yucel O. Endometriosis, Leiomyoma and Adenomyosis: the Risk of Gynecologic Malignancy. Asian Pac J Cancer Prev. 2013;14(10):5589-97 DOI: https://doi.org/10.7314/APJCP.2013.14.10.5589 Bawazeer NA, Al-Jifree HM, Gari AM. Malignant transformation of persistent endometriosis after hysterectomy. Saudi Med J. 2014;35(11):1390-2 McDermott S; Oei T N, Iyer VR, Lee SI. MR Imaging of Malig¬nancies Arising in Endo¬metriomas and Extra¬ovarian Endometriosis. Radiographics. 2012;32(3):845-63. DOI: https://doi.org/10.1148/rg.323115736 Ren F, Wang DB, Li T, Chen YH, Li Y. Identification of differentially methylated genes in the malignant transformation of ovarian endometriosis. J Ovarian Res. 2014;10;7:73. DOI: https://doi.org/10.1186/1757-2215-7-73 Ijichi S, Mori T, Suganuma I, Yamamoto T, Matsushima H, Ito F et al. Clear Cell Carcinoma Arising from Cesarean Section Scar Endometriosis: Case Report and Review of the Literature. Case Rep Obstet Gynecol. 2014;2014:642483. DOI: https://doi.org/10.1155/2014/642483 Wang CT, Wang DB, Liu KR, Li Y, Sun CX, Guo CS et al. Inducing malignant transformation of endometriosis in rats by long-term sustaining hyperestrogenemia and type II diabetes. Cancer Sci. 2015;106(1):43-50. DOI: https://doi.org/10.1111/cas.12573 Suryawanshi S, Huang x, Elishaev E, Budiu RA, Zhang L, Kim SH et al. Complement Pathway is Frequently Altered in Endometriosis and Endometriosis-Associated Ovarian Cancer. Clin Cancer Res. 2014;20(23):6163-74. DOI: https://doi.org/10.1158/1078-0432.CCR-14-1338 Dong M, Yang P, Hua F. miR-191 Modulates Malignant Transformation of Endometriosis Through Regulating TIMP3. Med Sci Monit. 2015;21:915-20. DOI: https://doi.org/10.12659/MSM.893872 Wei JJ, William J, Bulun S. Endometriosis and Ovarian Cancer: A Review of Clinical, Pathologic, and Molecular Aspects. Int J Gynecol Pathol. 2011; 30(6): 553–68. DOI: https://doi.org/10.1097/PGP.0b013e31821f4b85 Tanase Y, Furukawa N; Kobayashi H, Matsumoto T . Malignant Transformation from Endometriosis to Atypical Endometriosis and Finally to Endometrioid Adenocarcinoma within 10 Years. Case Rep Oncol. 2013;6:480–4. DOI: https://doi.org/10.1159/000355282 Terasa T. Endometrioid adenocarcinoma of the ovary arising in atypical endometriosis. Int J Clin Exp Pathol. 2012;5(9):924-7. Sosa-Durán EE, et al. Adenocarcinoma de células claras originado de endometriosis en pared abdominal. Cir Cir. 2015 Aug 10. pii: S0009-7411(15)00152-8. Tarumi Y, Mori T, Kusuki I, Ito F E Kitawaki J. Endometrioid adenocarcinoma arising from deep infiltrating endometriosis involving the bladder: A case report and review of the literature. Gynecol Oncol Rep. 2015;15;13:68-70. DOI: https://doi.org/10.1016/j.gore.2015.07.003 Downloads Publicado Edição Seção Licença Copyright (c) 2017 Arquivos Catarinenses de Medicina Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

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