Benign germ cell tumour and epithelial carcinoma – Rare synchronous presentation in unilateral ovary on background of endometriosis

Swati Satish Kadam
In: Indian Journal of Pathology and Oncology · 2022 · vol. 9(1) , pp. 97–100 · doi:10.18231/j.ijpo.2022.024 · W4213007063
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This case report describes the rare synchronous occurrence of a benign cystic teratoma, endometrioid adenocarcinoma, and clear cell carcinoma in a single ovary affected by endometriosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This paper reports a single 50-year-old woman with irregular menses and an enlarged cystic ovarian mass, in whom imaging and gross pathology revealed synchronous benign and malignant lesions within the same unilateral ovary on a background of endometriosis. Histology showed well-differentiated endometrioid adenocarcinoma grade 2 with squamous metaplasia and a nodule of clear cell carcinoma on background of borderline endometrioid tumor and endometriosis, alongside a separate mature cystic teratoma, with no capsular or vascular invasion; the uterus also had adenomyosis and benign endometrial polyp, while the contralateral ovary had endometriosis. The authors explicitly frame this as an extremely rare, likely coincidental combination because a literature review found no similar reported case and they note the absence of clinical evidence for hereditary syndromic associations. This paper is centrally about endometriosis — it documents an unusual synchronous ovarian combination of endometriosis-related epithelial carcinomas (endometrioid and clear cell) with a benign germ cell tumor arising in the setting of ovarian endometriosis.

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Abstract

Ovarian carcimomas are the second most common gynecological malignancy of which more than 90% arise from surface epithelial cells. Endometriosis-related ovarian neoplasms (ERONs) are described as a group of tumors which include clear cell carcinoma, endometrioid carcinoma, and seromucinous borderline tumor. Benign cystic teratomas are commonest benign ovarian neoplasms derived from germ cells. Coexistence of benign cystic teratoma, endometrioid adenocarcinoma and clear cell carcinoma in the same ovary is very unusual. Our case presented with well differentiated endometrioid adenocarcinoma grade 2 with squamous metaplasia and a nodule of clear cell carcinoma on the background of endometriosis and benign cystic teratoma in the same ovary. To the best of our knowledge, this is the first case with such an unusual combination to be reported in the medical English literature.

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endometriosis

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