Adenomyosis is Associated With Myometrial Invasion by FIGO 1 Endometrial Adenocarcinoma

Ismiil ND, Nadia Ismiil, Nadia D Ismiil, Golnar Rasty, Rasty G, Zeina Ghorab, Ghorab Z, Sharon Nofech-Mozes, Nofech-Mozes S, Sharon Nofech‐Mozes, Bernardini M, Marcus Bernardini, Marcus Q. Bernardini, Thomas G, Gillian Thomas, Ackerman I, Ida Ackerman, Covens A, Allan Covens, Mahmoud A. Khalifa, Khalifa MA
International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists · 2007 · vol. 26(3) , pp. 278–283 · doi:10.1097/01.pgp.0000235064.93182.ec · PMID:17413981 · W2067749807
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FIGO grade 1 endometrial endometrioid adenocarcinoma involving adenomyosis demonstrates a significantly higher rate of myometrial invasion compared to tumors occurring without adenomyosis.

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This retrospective study examined whether the presence of adenomyosis influences the risk of myometrial invasion in patients with FIGO grade 1 endometrioid adenocarcinoma. Researchers analyzed hysterectomy specimens from 46 cases with cancer-positive adenomyosis and 49 cases without adenomyosis, utilizing CD10 staining to confirm invasion patterns. The findings revealed that myometrial invasion occurred significantly more frequently in the adenomyosis group (91.3%) compared to those without the condition (77.5%), suggesting that coexistent adenomyosis may increase the tumor's interface with the myometrium and facilitate deeper penetration. This paper is centrally about adenomyosis — specifically its association with increased myometrial invasion risk in early-stage endometrial cancer.

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Abstract

Adenomyosis is commonly seen in hysterectomy specimens for endometrial adenocarcinoma where it could be involved with the tumor. When adenocarcinoma involves adenomyosis, the tumor may remain limited to the adenomyosis or proceeds to invade the adjacent myometrium. The purpose of this study was to investigate whether the risk of myometrial invasion by grade 1 endometrioid adenocarcinoma in cases with cancer-positive adenomyosis is different from that of cases where cancer occurs in the absence of adenomyosis. Forty-six consecutive hysterectomy specimens with International Federation of Gynecology and Obstetrics (FIGO) grade 1 endometrial endometrioid adenocarcinoma involving adenomyosis and 49 consecutive specimens with the same tumor occurring in the absence of adenomyosis were retrospectively studied by 4 experienced gynecologic pathologists. In cases with adenomyosis, myometrial invasion was confirmed by CD10-negative staining around glands with irregular outline surrounded by inflamed desmoplastic stroma. Myometrial invasion was found in significantly more adenomyosis cases (n = 42, 91.3%) than in cases without adenomyosis (n = 38, 77.5%) (chi = 4.79, P = 0.03). In 16 cases of the former group, the invasion only occurred from the foci of adenomyosis. Although myometrial invasion in the outer half was more common in the adenomyosis group (n = 16, 34.8%) than in cases without adenomyosis (n = 9, 18.4%), the difference was not statistically significant (chi = 3.29, P = 0.07). By involving coexistent adenomyosis, FIGO grade 1 endometrial endometrioid adenocarcinoma is associated with myometrial invasion, probably through increasing the surface area of its interface with the adjacent myometrium. When compared with their counterparts that occur in the absence of adenomyosis, these tumors are significantly more likely to invade the myometrium.
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Adenomyosis is Associated With Myometrial Invasion by FIGO 1 Endometrial Adenocarcinoma - Nadia D. Ismiil - Golnar Rasty - Zeina Ghorab - Sharon Nofech-Mozes - Marcus Bernardini - Gillian Thomas - Ida Ackerman - Allan Covens - Mahmoud A. Khalifa Summary: Adenomyosis is commonly seen in hysterectomy specimens for endometrial adenocarcinoma where it could be involved with the tumor. When adenocarcinoma involves adenomyosis, the tumor may remain limited to the adenomyosis or proceeds to invade the adjacent myometrium. The purpose of this study was to investigate whether the risk of myometrial invasion by grade 1 endometrioid adenocarcinoma in cases with cancer-positive adenomyosis is different from that of cases where cancer occurs in the absence of adenomyosis. Forty-six consecutive hysterectomy specimens with International Federation of Gynecology and Obstetrics (FIGO) grade 1 endometrial endometrioid adenocarcinoma involving adenomyosis and 49 consecutive specimens with the same tumor occurring in the absence of adenomyosis were retrospectively studied by 4 experienced gynecologic pathologists. In cases with adenomyosis, myometrial invasion was confirmed by CD10-negative staining around glands with irregular outline surrounded by inflamed desmoplastic stroma. Myometrial invasion was found in significantly more adenomyosis cases (n = 42, 91.3%) than in cases without adenomyosis (n = 38, 77.5%) (χ2 = 4.79, P = 0.03). In 16 cases of the former group, the invasion only occurred from the foci of adenomyosis. Although myometrial invasion in the outer half was more common in the adenomyosis group (n = 16, 34.8%) than in cases without adenomyosis (n = 9, 18.4%), the difference was not statistically significant (χ2 = 3.29, P = 0.07). By involving coexistent adenomyosis, FIGO grade 1 endometrial endometrioid adenocarcinoma is associated with myometrial invasion, probably through increasing the surface area of its interface with the adjacent myometrium. When compared with their counterparts that occur in the absence of adenomyosis, these tumors are significantly more likely to invade the myometrium.

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Condition tags

endometriosisadenomyosis

MeSH descriptors

Adenocarcinoma Endometrial Neoplasms Endometriosis Myometrium Adenocarcinoma Adenocarcinoma Adenocarcinoma Adult Aged Aged, 80 and over Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometriosis Endometriosis Endometriosis Female Humans Immunohistochemistry Middle Aged

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