Endometriosis-associated Malignancy

N Krawczyk, Natalia Krawczyk, Malgorzata Banys-Paluchowski, M Banys-Paluchowski, D Schmidt, U Ulrich, Tanja Fehm, T Fehm
Geburtshilfe und Frauenheilkunde · 2016 · vol. 76(02) , pp. 176–181 · doi:10.1055/s-0035-1558239 · PMID:26941451 · PMC4771509 · W2326554766
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

This paper defines endometriosis-associated malignancy, noting its frequent ovarian location, potential derivation from atypical endometriosis, common genetic alterations, and association with younger patients and favorable outcomes for ovarian subtypes.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This review examines endometriosis-associated malignancies (EAM), focusing on epidemiologic evidence linking endometriosis with cancer risk, the histologic criteria used to define EAM, and the tumor types and molecular alterations reported in endometriosis-associated ovarian cancer (EAOC). Across cohort and case-control studies, ovarian cancer risk among women with endometriosis is reported as modestly increased overall (with some stronger associations), but the paper notes that direct causality has not been clarified and highlights explicit limitations such as possible confounding by infertility and overestimation when endometriomas were diagnosed largely by ultrasound rather than histology. Histologically, EAM is defined using criteria including endometriosis adjacent to tumor, exclusion of other primary sources, and evidence of transition from benign endometriosis to malignancy, with about 80% occurring in the ovary and extragonadal disease often in sites such as bowel and rectovaginal structures; EAOC is most often well/intermediately differentiated endometrioid or clear cell carcinoma and tends to be diagnosed earlier in younger women. The paper does discuss endometriosis extensively and centers on the concept of endometriosis-associated malignancy, including EAOC histology, epidemiology, and proposed pathogenesis.

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Abstract

Endometriosis is a common condition in women of reproductive age. According to several epidemiological studies endometriosis may be associated with increased risk of various malignancies. However, endometriosis-associated malignancy (EAM) is defined by certain histological criteria. About 80 % of EAM have been found in the ovary, whereas 20 % are localized in extragonadal sites like intestine, rectovaginal septum, abdominal wall, pleura and others. Some authors suggest that EAM arise from atypical endometriosis as an intermediate lesion between endometriosis and cancer. Moreover, a number of genetic alterations, like loss of heterozygosity (LOH), PTEN, ARID1 A and p53 mutations have been found in both endometriosis and EAM. Endometriosis-associated ovarian cancer (EAOC) is mostly a well or intermediately differentiated tumor of endometrioid or clear cell histological sub-type. Women affected by EAOC are on average five to ten years younger than non-EAOC patients; in most of the cases EAOC is a low stage disease with favorable clinical outcome. Since EAM is a rare condition systematic data on EAM are still missing. A systematic retrospective study on endometriosis-associated malignancies (EAM study) is currently being conducted by the Endometriosis Research Foundation together with the study groups on ovarian and uterine tumors of the working group for gynecological oncology (AGO) ([email protected]).

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endometriosis

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