Atypical endometriosis: a clinicopathologic study of 163 cases

Abstract

OBJECTIVE To investigate the clinicopathologic features of atypical endometriosis (AEM), and to discuss the relations between AEMs and tumors. METHODS A retrospective analysis was performed on 163 cases of AEMs. The changes in the glandular epithelium, stroma, and their background and the relationship with coexisting tumors were observed. RESULTS The AEMs account of for 4.4% (163/3,724) of the endometriosis (EM) cases. Of 172 AEM foci of 163 patients, 168 were in the ovary, and the other 4 were in the fallopian tube, cervix and uterine serosa. Of the cases of ovarian EM, 6.8% were AEM. All of the 27 cases (15.7%) of the AEMs associated with a tumor were found in the ovaries, of which 15 were malignant, 9 borderline, and 3 benign. Of the ovary AEMs, 14.9% were associated with a borderline or malignant tumor. The AEM epithelia were mainly arranged in the form of surface epithelia, with only a few glands. Present were characteristic features of moderate to marked pleomorphism, epithelial tufting, bud or firework-like structures on microscopy. Epithelial metaplastic changes were observed in 86 cases (50%) of the 172 AEM foci. Epithelium, endometrioid stroma, and fibrotic-collagen formed a three-layer structure in the wall of the AEM cysts. The endometrioid stroma were usually thin compared to the fibro-collagen tissue. The transformation from an AEM to a tumor was found in most of the malignant tumors. CONCLUSIONAEM lesions have some features which are similar and also differ from both of the tumor and EM. AEMs have a relative higher potential for tumorigenesis and canceration, especially for ovarian cancer. The process of damage, repair, and scarring in EM foci over a long period may play a role in the development of EM into AEM and eventally into tumor formation.

Atypical Endometriosis: Comprehensive Characterization of Clinicopathologic, Immunohistochemical, and Molecular Features

“…In this study, we report 36 cases of A-EMS and expand the morphologic, immunohistochemical, and molecular understanding of this atypical lesion. A-EMS is described as a rare phenomenon, comprising 1.7% to 4.4% of all endometriotic lesions (5,6,9). Our data appears to be similar, since cases evaluated represent <1% of all EMS cases reported over an…”

“…In this study, we report 36 cases of A-EMS and expand the morphologic, immunohistochemical, and molecular understanding of this atypical lesion. A-EMS is described as a rare phenomenon, comprising 1.7% to 4.4% of all endometriotic lesions 5,6,9 . Our data appears to be similar, since cases evaluated represent <1% of all EMS cases reported over an 11-yr period (although not all cases were retrospectively evaluated for the presence of atypical features, and we relied on the description of atypia in the report for identification of E-AMS cases).…”

Transmembrane Estrogen Receptor GPR30 is More Frequently Expressed in Malignant Than Benign Ovarian Endometriotic Cysts and Correlates With MMP-9 Expression

“…In recent years, it has been reported that atypical endometriosis occurs in up to 6.8% of the cases of ovarian cancer, and ovarian endometrioid carcinomas occurring with endometriosis have more atypical changes. 3 Malignant transformation of endometriosis is becoming an important concern in the field of gynecology. Compared with benign ovarian endometriosis, alteration of molecular proteins has been reported in endometriosis-associated ovarian carcinoma (EAOC), such as estrogen receptors (ERs), progesterone receptors, phosphatase and tensin homolog, 4 P53, and bcl-2 protein.…”

The Expression of GPR30 in Iron-Overloaded Atypical Ovarian Epithelium and Ectopic Endometrium Is Closely Correlated with Transferrin Receptor and Pi3K

“…Molecular and epidemiological studies have also provided a strong association between atypical endometriosis and ovarian cancer [ 1 , 2 ]. It has been reported that atypical endometriosis occurs in up to 6.8% of ovarian cancer cases, and ovarian endometrioid carcinoma originating from ectopic endometrium is more prone to atypical changes [ 3 ]. These factors, therefore, demonstrate a high risk of type I ovarian cancer in women with these atypical cells and/or the structure of ovarian endometriosis.…”