Malignancy Risks Associated with Endometriosis: Clinical Aspects

Endometriosis, although benign, shares some characteristics with malignant tumors. Especially regarding ovarian cancer, there is a slightly higher risk to develop a malignant tumor for patients with endometriosis. Clinical evidence suggests a transformation by endometriosis into malignant tissue through “atypical endometriosis.” Malignant transformation arising from endometriotic lesions is well defined, when the criteria are met it is called an endometriosis-associated malignancy. Between 80% and 90% are located in the ovary, while only 10–20% are at extragonadal sites. A number of risk factors as well as protective factors for the development of an EAM have been identified. Clinical presentation is different from non-endometriosis-associated malignancies. Transvaginal ultrasound is pivotal for the diagnosis of an endometriosis-associated ovarian cancer, and there is a guideline to differentiate endometrioma from EAOC. In the absence of clinical data, therapy for EAOC is the same as for ovarian cancer, while for extragonadal EAM there is a lack of clear guidelines. Overall, the surgical concept of therapy for premenopausal patients with endometriosis should generally not be influenced by the slightly higher risk for ovarian cancer. Yet, there are important clinical implications of what we know about EAM and EAOC that should be taken into account when counseling patients. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

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