Ovarian cancer in endometriosis: molecular biology, pathology, and clinical management

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Endometriosis is a neoplastic disease and precursor to ovarian cancer, influenced by microenvironmental factors, with clear cell carcinoma potentially requiring specific molecular targeting strategies.

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This paper reviews evidence that endometriosis behaves as a monoclonal, neoplastic condition and can serve as a precursor to endometriosis-associated ovarian cancer (EAOC), particularly the endometrioid and clear cell subtypes, focusing on molecular and pathological findings. It highlights reported genetic and molecular events in EAOC—including p53 alterations, PTEN silencing, K-ras mutations, and HNF-1 activation—and notes the paper’s recent data suggesting that oxidative stress and inflammation in the microenvironment contribute to carcinogenesis and phenotype, while also stating that the precise mechanism remains poorly understood. A key limitation emphasized is that management of endometriosis through the lens of EAOC is not standardized due to incomplete understanding of the natural course and risk factors for malignant transformation, with clear cell carcinoma requiring a specific treatment strategy including molecular targeting. This paper is centrally about endometriosis — it specifically discusses endometriosis as a monoclonal precursor to endometriosis-associated ovarian cancer and the molecular/pathological mechanisms of malignant transformation.

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Abstract

Recent molecular and pathological evidence suggests that endometriosis is a monoclonal, neoplastic disease. Moreover, endometriosis serves as a precursor of ovarian cancer (endometriosis-associated ovarian cancer; EAOC), especially of the endometrioid and clear cell subtypes. Although a variety of molecular events, such as p53 alteration, PTEN silencing, K-ras mutations, and HNF-1 activation, have been identified in EAOC, its precise carcinogenic mechanism remains poorly understood. Our recent data indicate that microenvironmental factors, including oxidative stress and inflammation, play an important role in the carcinogenesis and phenotype of EAOC. The management of endometriosis from the standpoint of EAOC is not standardized yet. To this end, clarification of the precise natural course and the risk factors that contribute to malignant transformation remain important goals. Among the phenotypes of EAOC, clear cell carcinoma, seems to require a specific treatment strategy, including molecular targeting.
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Abstract

Recent molecular and pathological evidence suggests that endometriosis is a monoclonal, neoplastic disease. Moreover, endometriosis serves as a precursor of ovarian cancer (endometriosis-associated ovarian cancer; EAOC), especially of the endometrioid and clear cell subtypes. Although a variety of molecular events, such as p53 alteration, PTEN silencing, K-ras mutations, and HNF-1 activation, have been identified in EAOC, its precise carcinogenic mechanism remains poorly understood. Our recent data indicate that microenvironmental factors, including oxidative stress and inflammation, play an important role in the carcinogenesis and phenotype of EAOC. The management of endometriosis from the standpoint of EAOC is not standardized yet. To this end, clarification of the precise natural course and the risk factors that contribute to malignant transformation remain important goals. Among the phenotypes of EAOC, clear cell carcinoma, seems to require a specific treatment strategy, including molecular targeting. Similar content being viewed by others

References

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(2005) Successful treatment of an aggressive recurrent post-menopausal endometriosis with an aromatase inhibitor. Reprod Biomed Online 11:455–457 Author information Authors and Affiliations Corresponding author About this article Cite this article Mandai, M., Yamaguchi, K., Matsumura, N. et al. Ovarian cancer in endometriosis: molecular biology, pathology, and clinical management. Int J Clin Oncol 14, 383–391 (2009). https://doi.org/10.1007/s10147-009-0935-y Received: Published: Issue date: DOI: https://doi.org/10.1007/s10147-009-0935-y

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Condition tags

endometriosis

MeSH descriptors

Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Cell Transformation, Neoplastic Cell Transformation, Neoplastic Cell Transformation, Neoplastic Cell Transformation, Neoplastic Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Ovarian Neoplasms

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