Study of prevalence of endometrial cancer in patients with adenomyosis uteri

The aim of the study was to evaluate the prevalence of adenomyosis in endometrial cancer patients and to determine the frequency of adenomyosis and endometrial cancer at hysterectomy specimens.

This study was carried out retrospectively on pathologic specimens of hysterectomies. A total of 98 women in the period May 2020 to January 2021enrolled to the study. All pathologies seen in hysterectomy specimens were noted. The frequency of adenomyosis and the accompanying pathologies were determined. These women were categorized into two groups according to the cause of hysterectomy. The incidence of adenomyosis was analyzed together with the endometrial cancer.

The incidence of adenomyosis was 22% at hysterectomy specimens. There was no statistically significant difference between the mean age of the two groups (p=0.002*). There were 22 cases with adenomyosis and the only pathologic finding was adenomyosis, in 22.7% of cases. The most common accompanying pathologies with adenomyosis were uterine myomas in 95% and on significant association was found in cases of endometrial carcinoma.

There is no evidence that adenomyosis increases the risk of endometrial cancer as there is no statistically significant difference found between the group with and the group without adenomyosis in terms of coexistence with endometrial carcinoma. Metrics

Frankl O. Adenomyosis uteri. Am J Obstet Gynecol. 1925;10:680-4. Parazzini F, Mais V, Cipriani S, Busacca M, Venturini P, GISE. Determinants of adenomyosis in women who underwent hysterectomy for benign gynecological conditions: results from a prospective multicentric study in Italy. Eur J Obstet Gynecol Reprod Biol. 2009;143(2):103-6. Peric H, Fraser IS. The symptomatology of adenomyosis. Best Pract Res Clin Obstet Gynaecol. 2006;20(4):547-55. Verit FF, Yucel O. Endometriosis, leiomyoma and adenomyosis: the risk of gynecologic malignancy. Asian Pac J Cancer Prev. 2013;14(10):5589-97. Koshiyama M, Okamoto T, Ueta M. The relationship between endometrial carcinoma and coexistent adenomyosis uteri, endometriosis externa and myoma uteri. Cancer Detect Prev. 2004;28(2):94-8. Musa F, Frey MK, Im HB, Chekmareva M, Ellenson LH, Holcomb K. Does the presence of adenomyosis and lymphovascular space invasion affect lymph node status in patients with endometrioid adenocarcinoma of the endometrium? Am J Obstet Gynecol. 2012;207(5):417. Mittal KR, Barwick KW. Endometrial adenocarcinoma involving adenomyosis without true myometrial invasion is characterized by frequent preceding estrogen therapy, low histologic grades, and excellent prognosis. Gynecol Oncol. 1993;49(2):197-201. Abushahin N, Zhang T, Chiang S, Zhang X, Hatch K, Zheng W. Serous endometrial intraepithelial carcinoma arising in adenomyosis: a report of 5 cases. Int J Gynecol Pathol. 2011;30(3):271-81. Ismiil N, Rasty G, Ghorab Z, Mozes S, Bernardini M, Ackerman I, et al. Adenomyosis involved by endometrial adenocarcinoma is a significant risk factor for deep myometrial invasion. Ann Diagn Pathol. 2007;11(4):252-7. Vercellini P, Viganò P, Somigliana E, Daguati R, Abbiati A, Fedele L. Adenomyosis: epidemiological factors. Best Pract Res Clin Obstet Gynaecol. 2006;20(4):465-77. Inoue S, Hirota Y, Ueno T, Fukui Y, Yoshida E, Hayashi T, et al. Uterine adenomyosis is an oligoclonal disorder associated with KRAS mutations. Nat Commun. 2019;10(1):5785. Tanos V, Lingwood L, Balami S. Junctional Zone Endometrium Morphological Characteristics and Functionality: Review of the Literature. Gynecol Obstet Invest. 2020;85(2):107-17. Couto D, Mota F, Silva T, Oliveira C. Adenocarcinoma arising in adenomyosis: report of an unusual case. Acta Obstet Gynecol Scand. 2004;83(4):406-8. Koshiyama M, Suzuki A, Ozawa M, Fujita K, Sakakibara A, Kawamura M, et al. Adenocarcinomas arising from uterine adenomyosis: a report of four cases. Int J Gynecol Pathol. 2002;21(3):239-45. Colman HI, Rosenthal AH. Carcinoma developing in areas of adenomyosis. Obstet Gynecol. 1959;14:342-8. Koshiyama M, Okamoto T, Ueta M. The relationship between endometrial carcinoma and coexistent adenomyosis uteri, endometriosis externa and myoma uteri. Cancer Detect Prev. 2004;28(2):94-8. Parazzini F, Mais V, Cipriani S, Busacca M, Venturini P, GISE. Determinants of adenomyosis in women who underwent hysterectomy for benign gynecological conditions: results from a prospective multicentric study in Italy. Eur J Obstet Gynecol Reprod Biol. 2009;143(2):103-6. Ferenczy A. Pathophysiology of adenomyosis. Hum Reprod Update. 1998;4(4):312-22. Bergeron C, Amant F, Ferenczy A. Pathology and physiopathology of adenomyosis. Best Pract Res Clin Obstet Gynaecol. 2006;20(4):511-21. Gün I, Oner O, Bodur S, Ozdamar O, Atay V. Is adenomyosis associated with the risk of endometrial cancer? Med Glas. 2012;9(2):268-72.