Three cases of clear-cell adenocarcinoma arising from endometrioma during hormonal treatments

Osamu Yoshino, Yoshino O, Takashi Minamisaka, Minamisaka T, Yosuke Ono, Ono Y, Sayaka Tsuda, Tsuda S, Samejima A, Azusa Samejima, Tomoko Shima, Shima T, Akitoshi Nakashima, Nakashima A, Kaori Koga, Osuga Y, Yutaka Osuga, Shigeru Saito, Saito S
Journal of Obstetrics and Gynaecology Research · 2018 · vol. 44(9) , pp. 1850–1858 · doi:10.1111/jog.13702 · PMID:29998468 · W2837092139
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This report details three cases where clear-cell adenocarcinoma developed from endometriomas during GnRH analogue, tamoxifen, low-dose estrogen-progestin, or dienogest therapy, despite the treatments shrinking the endometriomas.

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Abstract

Endometrioma is known to be an occurrence site of ovarian cancer, but there is no evidence on how to reduce the risk of canceration. Here, we report three cases of ovarian cancer arising from endometrioma during hormone therapies of GnRH analogue and tamoxifen, low-dose estrogen-progestin (LEP) and dienogest. In all cases, each hormonal treatment was effective in shrinking the size of the endometrioma. During hormonal treatments, solid parts inside endometrioma were observed, which was followed by surgery. The histology of the solid parts was clear-cell adenocarcinoma in all cases. An immunohistochemistry study demonstrated that the estrogen receptor (ER) and progesterone receptor (PR) were positive in the endometriosis part but negative in the cancer part, while the human EGF receptor (HER) 2 was negative or very weak in the benign part and positive in the malignant part in all three cases. Even though hormonal treatments seem to be effective to regulate endometrioma, careful observation is needed to follow-up patients with endometrioma.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Adenocarcinoma, Clear Cell Endometriosis Endometriosis Hormone Antagonists Ovarian Neoplasms Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adult Adult Endometriosis Endometriosis Female Female Hormone Antagonists Hormone Antagonists Humans Humans Middle Aged Middle Aged Ovarian Neoplasms

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References (33)

Cited by (6)

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License: CC0 · commercial use OK