Coexisting Ovarian Malignancy in Young Women With Endometrial Cancer

Abstract

Careful preoperative and intraoperative assessment of the adnexa is mandatory in young women with endometrial cancer. Those who desire ovarian preservation should be counseled regarding the high rate of coexisting ovarian malignancy.

Ovarian preservation during the surgical treatment of early stage endometrial cancer: A nation-wide study conducted by the Korean Gynecologic Oncology Group

“…Nevertheless, there has not been much debate regarding the topic of ovarian preservation in the field of surgical treatment as coexisting metastasis and synchronous ovarian tumor in patients with endometrial cancer has been thought to be 'common'. Some reports show an incidence of ovarian malignancy in subsets of young patients in the 5-29% range [11][12][13][14][15], which seems to be high, but these figures do not provide a rational for eradicating ovaries in all young women. Gistch et al reported the highest ovarian synchronous malignancy rate (29%), but the total number of patients was only 17, and they noted occult metastasis in grossly normal looking ovaries in one case only (1/17, 5.9%) [12].…”

“…Evans-Metcalf et al reported on the risk of occult malignancy in grossly normal appearing ovary (1 among 24 coexisting ovarian malignancies) in young women at time of surgery [13]. Walsh et al reported that 15% with benign appearing ovaries at time of surgery were found to have a tumor in adnexa at final examination [15]. However, these reports failed to mention whether other evidence of extrauterine disease was present.…”

A Rare Case of Synchronous Genital Carcinoma Involving the Endocervix and Bilateral Fallopian Tubes

“…Based on our data, it is important to examine in detail the adnexa in all hysterectomy specimens. 1 With widespread use of transvaginal sonography, more cases of fallopian tube carcinoma may be discovered preoperatively, allowing better chances for treatment. 6 Though synchronous carcinoma of the endocervix and fallopian tubes is rare, we need to keep in mind the pathology of fallopian tube when a patient comes with persistent watery discharge per vagina of unknown cause, which is rare but pathognomonic symptoms occurring only in 9% of fallopian tube carcinomas.…”

“…It has been postulated that embryologically similar tissues may be subjected to the same carcinogenic or hormonal stimuli and thereby develop synchronous neoplasm. 1 We present a rare case of a 53-year-old postmenopausal woman operated by radical hysterectomy for endocervical carcinoma. Fallopian tubes on both sides also showed papillary tumor within its lumen, thereby manifesting as synchronous trifocal mucinous papillary adenocarcinoma involving endocervix and both fallopian tubes.…”

Premenopausal early-stage endometrial carcinoma patients with low CA-125 levels and low tumor grade may undergo ovary-saving surgery

“…Several reports have estimated that the incidence of coexisting ovarian malignancy (primary or metastatic) is 5-29% of patients with endometrial carcinoma. [3][4][5] The prognosis of primary or metastatic ovarian cancers is quite different. Some investigators reported that synchronous early-stage ovarian cancers coexisting with endometrial cancers showed a favorable prognosis.…”