Endometrial adenocarcinoma arising in adenomyosis: case report and review of literature

In: European Journal of Gynaecological Oncology · 2020 · vol. 41(6) , pp. 858 · doi:10.31083/j.ejgo.2020.06.2174 · W3113228924
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This report describes a rare case of endometrial adenocarcinoma arising within adenomyosis, distinct from concurrent endometrial cancer and adenomyosis, and recommends considering this diagnosis in affected patients.

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This case report and literature review examines the rare occurrence of endometrial adenocarcinoma arising directly within adenomyotic tissue, distinct from concurrent cancers. The authors present a specific case of a 62-year-old asymptomatic woman diagnosed with this condition to highlight its clinical significance. They emphasize that physicians should consider this diagnosis in patients with intact endometrium and vaginal bleeding, as well as those with a history of adenomyosis regardless of current symptoms. The paper recommends periodic follow-up for women diagnosed with adenomyosis during their reproductive years to monitor for such malignant transformations. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

Adenomyosis is a common benign gynecological condition in women of reproductive age. While endometrial cancer co-existing with adenomyosis is common, endometrial carcinoma arising from endometrial cells within adenomyosis (EC-AIA) is rare. We present an unusual case of EC-AIA in a 62-year-old woman with no clinical symptoms. EC-AIA should be considered as a different diagnosis from concurrent endometrial cancer and adenomyosis. EC-AIA should also be considered in adenomyosis patients with intact endometrium and vaginal bleeding and in those with a history of adenomyosis at reproductive age regardless of the occurrence of vaginal bleeding. Periodic follow-up is recommended in women diagnosed with adenomyosis at reproductive age.
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Title Author DOI Article Type Special Issue Volume Issue Search - Views 3279 - Dowloads 158 Endometrial adenocarcinoma arising in adenomyosis: case report and review of literature 1Department of Obstetrics and Gynecology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, 892 Dongnam-ro, Gangdong-gu, Seoul 05278, Korea DOI: 10.31083/j.ejgo.2020.06.2174 Vol.41,Issue 6,December 2020 pp.858-862 Submitted: 21 June 2020 Accepted: 12 August 2020 Published: 15 December 2020 *Corresponding Author(s): Seung Yeon Pyeon E-mail: [email protected] Adenomyosis is a common benign gynecological condition in women of reproductive age. While endometrial cancer co-existing with adenomyosis is common, endometrial carcinoma arising from endometrial cells within adenomyosis (EC-AIA) is rare. We present an unusual case of EC-AIA in a 62-year-old woman with no clinical symptoms. EC-AIA should be considered as a different diagnosis from concurrent endometrial cancer and adenomyosis. EC-AIA should also be considered in adenomyosis patients with intact endometrium and vaginal bleeding and in those with a history of adenomyosis at reproductive age regardless of the occurrence of vaginal bleeding. Periodic follow-up is recommended in women diagnosed with adenomyosis at reproductive age. Adenomyosis; Endometrial cancer; Endometrial adenocarcinoma. Yun Jin Bang,Jong-Min Lee,Seung Yeon Pyeon. Endometrial adenocarcinoma arising in adenomyosis: case report and review of literature. European Journal of Gynaecological Oncology. 2020. 41(6);858-862. [1] Lin X.L., Hai N., Zhang J., Han Z.Y., Yu J., Liu F., et al.: “Compar-ison between microwave ablation and radiofrequency ablation for treating symptomatic uterine adenomyosis”. Int. J. Hyperthermia, 2020, 37, 151-156. [2] Leyendecker G., Wildt L.: “A new concept of endometriosis and adenomyosis: Tissue injury and repair (Tiar)”. Horm. Mol. Biol. Clin. Investig., 2011, 5, 125-142. [3] Tetikkurt S., Celik E., Tas H., Cay T., Isik S., Usta A.T.: “Coexistence of adenomyosis, adenocarcinoma, endometrial and myometrial lesions in resected uterine specimens”. Mol. Clin. Oncol., 2018, 9, 231-237. [4] Zhang Z., Yang B., Zhang W., Gao X., Zhao C., Zhang X., et al.: “Clinicopathological characteristics and survival outcomes of patients with coexistence of adenomyosis and endometrial carcinoma”. Int. J. Clin. Exp. Pathol., 2018, 11, 956-962. [5] Matsuo K., Cahoon S.S., Gualtieri M., Scannell C.A., Jung C.E., Takano T. et al.: “Significance of adenomyosis on tumor progression and survival outcome of endometrial cancer”. Ann. Surg. On-col., 2014, 21, 4246-4255. [6] Colman H.I., Rosenthal A.H.: “Carcinoma developing in areas of adenomyosis”. Obstet. Gynecol., 1959, 14, 342-348. [7] Baba A., Yamazoe S., Dogru M., Ogawa M., Takamatsu K., Miyauchi J.: “Clear Cell Adenocarcinoma Arising from Adenomyotic Cyst: A case report and literature review”. J. Obstet. Gynaecol. Res., 2016, 42, 217-223. [8] Heo S.H., Lee K.H., Kim J.W., Jeong Y.Y.: “Unusual manifesta-tion of endometrioid adenocarcinoma arising from subserosal cystic adenomyosis of the uterus: emphasis on mri and positron emission tomography Ct findings”. Br. J. Radiol., 2011, 84, e210-e212. [9] Hsu M.I., Chou S.Y., Lin S.E., Liang, S.J., Chiu H.C., Hsu C.S.: “Very early stage adenocarcinoma arising from adenomyosis in the uterus”. Taiwan J. Obstet. Gynecol., 2006, 45, 346-349. [10] Izadi-Mood N., Samadi N., Sarmadi S., Eftekhar Z.: “Papillary serous carcinoma arising from adenomyosis presenting as intramural leiomyoma”. Arch. Iran. Med., 2007, 10, 258-260. [11] 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, 239-245. [12] Liu C.H., Chang W.H., Liu W.M., Wang P.H.: “Serous carcinoma arising from adenomyosis”. Taiwan J. Obstet. Gynecol., 2017, 56, 706- 707. [13] Lu B., Chen Q., Zhang X., Cheng L.: “Serous carcinoma arising from uterine adenomyosis/adenomyotic cyst of the cervical stump: A report of 3 cases”. Diagn. Pathol., 2016, 11, 46. [14] Mori M., Furusawa A., Kino N., Uno M., Ozaki Y., Yasugi T.: “Rare case of endometrioid adenocarcinoma arising from cystic adenomyosis”. J. Obstet. Gynaecol. Res., 2015, 41, 324-328. [15] Taga S., Sawada M., Nagai A., Yamamoto D., Hayase R.: “A case of endometrioid adenocarcinoma arising from adenomyosis”. Case Rep. Obstet. Gynecol., 2014, 2014, 569295. [16] Bagaria M., Shields E., Bakkum-Gamez J.N.: “Novel approaches to early detection of endometrial cancer”. Curr. Opin. Obstet. Gynecol., 2017, 29, 40-46. [17] Szegedi S., Koppan M., Varga T., Kovacs K., Tinneberg H.R., Bodis J.: “Endometrioid adenocarcinoma arising from adenomyosis: a case report”. Eur. J. Gynaecol. Oncol., 2016, 37, 858-860. [18] Kazandi M., Zeybek B., Terek M. C., Zekioglu O., Ozdemir N., Oztekin K.: “Grade 2 endometrioid adenocarcinoma arising from adenomyosis of the uterus: report of a case”. Eur. J. Gynaecol. On-col., 2010, 31, 719-721. Top

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