Prognostic Importance of Hyperplasia and Atypia in Endometriosis

J D Seidman, Jeffrey D. Seidman, Seidman JD
International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists · 1996 · vol. 15(1) , pp. 1–9 · doi:10.1097/00004347-199601000-00001 · PMID:8852439 · W2021444630
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This study evaluated 105 women with endometriosis and found that applying criteria for uterine endometrial hyperplasia may identify a small subset at increased risk for neoplastic transformation.

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This study evaluated the prognostic significance of cytologic atypia and hyperplasia in 105 women with endometriosis, utilizing Kurman-Norris criteria to distinguish between benign changes and early malignant transformation. Among the 62 patients followed for a mean of 8.7 years, two individuals diagnosed with early carcinoma subsequently developed adenocarcinoma or low malignant potential tumors, both presenting with multifocal disease. The authors concluded that these histological criteria can help identify rare cases where endometriosis carries an increased risk of neoplastic progression. This paper is centrally about endometriosis — specifically the risk of malignant transformation associated with atypical hyperplasia within endometriotic lesions.

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Abstract

Endometriosis occasionally exhibits cytologic atypia in the lining of endometriotic cysts or hyperplasia resembling uterine endometrial hyperplasias, but the risk of development of adenocarcinoma in these patients is unknown. A total of 105 women with endometriosis were studied: 37 with cytologic atypia (usually in the lining of endometriotic cysts), 34 with hyperplasia resembling uterine endometrial hyperplasia, and 34 controls. For lesions resembling eutopic endometrial hyperplasia, the Kurman-Norris criteria for separating atypical hyperplasia from well-differentiated endometrial adenocarcinoma were used to subdivide this group into 23 complex atypical hyperplasias and 11 "early carcinomas." Some 62 women were successfully followed for a mean of 8.7 years. One patient with early carcinoma developed a poorly differentiated endometrioid adenocarcinoma at the vaginal apex 8.1 years later. A second patient with early carcinoma developed a mullerian mucinous tumor of low malignant potential in the contralateral ovary 7 years later. Both of the latter two patients had multifocal endometriosis. Except for persistent benign endometriotic lesions in four patients, and breast carcinoma in one, all remaining patients were alive and well at last contact. It is concluded that the Kurman-Norris criteria for eutopic endometrial adenocarcinoma may be useful in identifying rare patients with endometriosis in whom there may be an increased risk of neoplastic transformation of their endometriosis.
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Prognostic Importance of Hyperplasia and Atypia in Endometriosis - Jeffrey D. Seidman Summary: Endometriosis occasionally exhibits cytologic atypia in the lining of endometriotic cysts or hyperplasia resembling uterine endometrial hyperplasias, but the risk of development of adenocarcinoma in these patients is unknown. A total of 105 women with endometriosis were studied: 37 with cytologic atypia (usually in the lining of endometriotic cysts), 34 with hyperplasia resembling uterine endometrial hyperplasia, and 34 controls. For lesions resembling eutopic endometrial hyperplasia, the Kurman-Norris criteria for separating atypical hyperplasia from well-differentiated endometrial adenocarcinoma were used to subdivide this group into 23 complex atypical hyperplasias and 11 “early carcinomas.” Some 62 women were successfully followed for a mean of 8.7 years. One patient with early carcinoma developed a poorly differentiated endometrioid adenocarcinoma at the vaginal apex 8.1 years later. A second patient with early carcinoma developed a mullerian mucinous tumor of low malignant potential in the contralateral ovary 7 years later. Both of the latter two patients had multifocal endometriosis. Except for persistent benign endometriotic lesions in four patients, and breast carcinoma in one, all remaining patients were alive and well at last contact. It is concluded that the Kurman-Norris criteria for eutopic endometrial adenocarcinoma may be useful in identifying rare patients with endometriosis in whom there may be an increased risk of neoplastic transformation of their endometriosis.

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Condition tags

endometriosis

MeSH descriptors

Endometrial Hyperplasia Endometriosis Adenocarcinoma Adenocarcinoma Adenocarcinoma Adult Cysts Cysts Endometrial Hyperplasia Endometrial Hyperplasia Endometriosis Endometriosis Endometriosis Female Humans Middle Aged Precancerous Conditions Precancerous Conditions Risk Factors Uterine Neoplasms

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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.

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