Malignancy arising in extraovarian endometriosis during estrogen stimulation.
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This review of 20 cases found that extraovarian endometriosis can undergo malignant transformation, most commonly in the vagina, presenting as adenocarcinoma, during unopposed estrogen stimulation.
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Abstract
OBJECTIVE: Endometriosis can undergo estrogen-dependent changes similar to endometrium and may carry a risk of developing hyperplasia and carcinoma during unopposed estrogen stimulation. MATERIAL-METHOD: We reviewed the existing literature to analyze the potential of a malignancy arising from extraovarian endometriosis by estrogen stimulation. RESULTS: To our knowledge, there are 20 published cases so far, with a malign transformed endometriosis during estrogen stimulation at an extraovarian site. The most common site of malignancy arising from endometriosis was the vagina (n = 5). The most common histological finding was adenocarcinoma (n = 13). The incidence of malignant transformation in extraovarian endometriosis during unopposed estrogen replacement can not be estimated based upon these case reports. CONCLUSION: Unopposed estrogen stimulation may lead to premalignant or malignant transformation in the residual foci of endometriosis. Therefore, the addition of progestins to estrogen replacement therapy should be considered in women who have undergone hysterectomy with oophorectomy because of endometriosis, especially if they are known to have residual endometriosis.
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Cited by (33)
- Endometriosis in Peri- and Postmenopausal Year 2022
- Endometriosis-associated Extraovarian Malignancies: A Challenging Question for the Clinician and the Pathologist 2020
- Surgical Menopause 2017
- Primary Vaginal Adenosarcoma With Sarcomatous Overgrowth Arising in Recurrent Endometriosis: Feasibility of Laparoscopic Treatment and Review of the Literature 2016
- Endometriosis and Cancer: Is There an Association? 2015
- Primary retroperitoneal Müllerian adenocarcinoma arising from endometriosis 2014
- Postmenopausal endometriosis: An enigma revisited 2014
- Endometrioid Adenocarcinoma in the Native Ureter of a Renal Transplant Patient: Case Report and Review of the Literature 2010
- The risk of malignancy in women with endometriosis 2010
- Adenocarcinoma endometrioide de ovário em parede abdominal 2010
- Endometriosis related to family history of malignancies in the Yale series 2009
- Malignant Chest Wall Endometriosis: A Case Report and Literature Review 2009
- Endometrioid adenocarcinoma presenting in a patient 18 years after hysterectomy: a potential hazard of unopposed oestrogen therapy 2009
- Endometriosis 2009
- Transformation maligne postménopausique d’une endométriose extragénitale. À propos d’un cas 2008
- Prognostic implication of endometriosis in clear cell carcinoma of the ovary 2008
- Postmenopausal endometriosis 2007
- Endometriosis: harmful survival of an ectopic tissue 2006
- Primary adenocarcinoma arising from endometriosis of the rectovaginal septum: a case report 2005
- Malignant extraovarian endometriosis: A review 2005
- Endometrioid adenocarcinoma with squamous differentiation arising from ureteral endometriosis in a patient with no history of gonadal endometriosis 2005
- Tratamiento de la endometriosis y medicina basada en la evidencia 2003
- Cervical Endometriosis Stimulated by Estrogen Therapy Following Supracervical Hysterectomy 2003
- Hormonal replacement therapy in surgical menopause with underlying endometriosis. 2003
- Ovarian and extraovarian endometriosis-associated cancer 2002
- Composite Tumor Consisting of Dermatofibrosarcoma Protuberans and Giant Cell Fibroblastoma Associated with Intratumoral Endometriosis 2001
- Malignancy in Endometriosis: Frequency and Comparison of Ovarian and Extraovarian Types 2001
- Diagnostic et suivi de l’endométriose en consultation : nouveautés 2001
- Unilateral hydronephrosis resulting from intraluminal obstruction of the ureter by adenosquamous endometrioid carcinoma arising from disseminated endometriosis 2000
- Oophorectomy at the time of surgery for moderate endometriosis: a survey of Australian gynaecologists 2000
- Medical management of endometriosis 2000
- Radical Surgery for Endometriosis 1999
- Malignancies arising in endometriosis 1999
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