Factors That Influence Endometriosis to Become a Malignancy: A Narrative Review

In: Indonesian Journal of Cancer · 2026 · vol. 20(1) , pp. 144–152 · doi:10.33371/ijoc.v20i1.1431 · W7147046522
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This narrative review examines the factors contributing to the malignant transformation of endometriosis into endometriosis-associated malignancies, with a primary focus on endometriosis-associated ovarian cancer. The authors identify specific genetic mutations such as PTEN, ARID1A, and p53 alterations, alongside clinical risk factors like postmenopausal status, older age, and hypoestrogenic conditions, as key drivers of this progression. Despite these insights, the paper notes that comprehensive data remains limited due to the rarity of endometriosis-associated malignancy. This paper is centrally about endometriosis — specifically investigating the mechanisms and risk factors for its malignant transformation into ovarian and extraovarian cancers.

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Abstract

Endometriosis frequently affects women of reproductive age, and epidemiologic studies suggest it may be linked to an elevated risk of malignancy. Specific histopathological criteria characterise endometriosis-associated malignancy (EAM). Endometriosis-associated ovarian cancer (EAOC) accounts for about 80% of EAM occurrences, with the remaining 20% occurring outside the ovaries. Genetic mutations, including PTEN, ARID1A, and p53 alterations, are identified in endometriosis and EAM. Factors such as postmenopausal status, older age, and hypoestrogenic conditions have also been linked to higher risks of EAM and EAOC. Due to EAM's rarity, comprehensive data remains limited. This review examines current EAM research, focusing on EAOC and its clinical relevance.
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Factors That Influence Endometriosis to Become a Malignancy: A Narrative Review DOI: https://doi.org/10.33371/ijoc.v20i1.1431Keywords: endometriosis, endometriosis-related malignancy, endometriosis-related ovarian cancer, gynecologic cancerAbstract Endometriosis frequently affects women of reproductive age, and epidemiologic studies suggest it may be linked to an elevated risk of malignancy. Specific histopathological criteria characterise endometriosis-associated malignancy (EAM). Endometriosis-associated ovarian cancer (EAOC) accounts for about 80% of EAM occurrences, with the remaining 20% occurring outside the ovaries. Genetic mutations, including PTEN, ARID1A, and p53 alterations, are identified in endometriosis and EAM. Factors such as postmenopausal status, older age, and hypoestrogenic conditions have also been linked to higher risks of EAM and EAOC. Due to EAM's rarity, comprehensive data remains limited. 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Fertil Steril. 2008 Nov;90(5):1559—70 Downloads Published How to Cite Issue Section License An author who publishes in the Indonesian Journal of Cancer agrees to the following terms: - The author retains the copyright and grants the journal the right of first publication of the work simultaneously licensed under the Creative Commons Attribution-NonCommercial 4.0 International License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal - The author is able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book) with the acknowledgement of its initial publication in this journal. - The author is permitted and encouraged to post his/her work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of the published work. 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