EP25.06: Coexistence of ovarian and endometrial cancer on the ground of endometriosis

Abstract

Endometriosis is defined as the presence of viable endometrial glands and stroma outside of the uterus. Endometrial foci may give rise to malignant tumours, it is estimated at 0,7-1,0%. Women with endometriosis have a two-to threefold increase in absolute risk of developing epithelial ovarian cancer, especially clear cell and endometrioid subtypes, seromucinous tumours known as endometriosis-associated ovarian carcinoma (EAOC). We present a case of 44 years old patient hospitalised in case of surgical treatment of ovarian cancer at the I Department of Gynecology and Obstetrics. During medical interview the patient reported short menstrual cycles, periodic abdominal pain and infertility, diagnosis of endometriosis has never been confirmed. The result of CA 125 was elevated (156.0 U/ml). Furthermore, during ultrasound, an ovarian mass sized 6 cm was detected and hypoechogenic infiltration with rich vascularisation was recognised in the middle of the cervix. Cytology of the cervix which was performed in Clinic-without abnormalities. During the operation a full oncological protocol for ovarian cancer was performed-in the intraoperative histopathological examination: malignant lesion. After the excision of the uterus the infiltration was confirmed, the iliac lymph nodes were collected on both sides. In diagnostic material ovarian cancer endometrioid subtypes was diagnosed, additionally endometrioma was described in which probably cancer progression had occurred. What's more synchronous endometrial cancer of an identical structure to ovarian tumour was diagnosed. There is potential correlation between occurrence of endometriosis and risk of developing malignant tumours. CA 125 antigen can help as an alert marker and prognostic factor. We should seek to eliminate the risk factors for ovarian and endometrial cancer in patients with diagnosed endometriosis, they should be under permanent gynecological care.