Malignant transformation of endometriosis and its clinical significance

Nezhat, Farr; Apostol, Radu; Mahmoud, Magda E.; Daouk, Manal El

doi:10.1016/j.fertnstert.2014.04.050

Cited by 42 publications

(40 citation statements)

References 3 publications

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“…Secondly, there is a concern that oestrogen will promote malignant transformation of residual endometriotic tissue. Sampson first described malignant transformation of ovarian endometriosis in 1925 ( Sampson, 1925 ) and although its pathogenesis is not fully understood, oxidative stress, inflammation and an altered hormonal milieu have been implicated as contributing factors ( Nezhat et al , 2014 ). Malignant transformation is thought to be a multistep pathway in which normal endometriotic tissue progresses to an atypical intermediate stage, and finally to invasive carcinoma ( Gadducci et al , 2014 ).…”

Section: Introductionmentioning

confidence: 99%

The management of menopause in women with a history of endometriosis: a systematic review

Gemmell

Webster

Kirtley

et al. 2017

Human Reproduction Update

101

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BACKGROUNDEndometriosis is typically regarded as a premenopausal disease, resolving after natural or iatrogenic menopause due to declining oestrogen levels. Nonetheless, case reports over the years have highlighted the incidence of recurrent postmenopausal endometriosis. It is now clear that both recurrence and malignant transformation of endometriotic foci can occur in the postmenopausal period. Postmenopausal women are commonly treated with hormone replacement therapy (HRT) to treat climacteric symptoms and prevent bone loss; however, HRT may reactivate endometriosis and stimulate malignant transformation in women with a history of endometriosis. Given the uncertain risks of initiating HRT, it is difficult to determine the best menopausal management for this group of women.OBJECTIVE AND RATIONALThe aim of this study was to systematically review the existing literature on management of menopausal symptoms in women with a history of endometriosis. We also aimed to evaluate the published literature on the risks associated with HRT in these women, and details regarding optimal formulations and timing (i.e. initiation and duration) of HRT.SEARCH METHODSFour electronic databases (MEDLINE via OVID, Embase via OVID, PsycINFO via OVID and CINAHL via EbscoHost) were searched from database inception until June 2016, using a combination of relevant controlled vocabulary terms and free-text terms related to ‘menopause’ and ‘endometriosis’. Inclusion criteria were: menopausal women with a history of endometriosis and menopausal treatment including HRT or other preparations. Case reports/series, observational studies and clinical trials were included. Narrative review articles, organizational guidelines and conference abstracts were excluded, as were studies that did not report on any form of menopausal management. Articles were assessed for risk of bias and quality using GRADE criteria.OUTCOMESWe present a synthesis of the existing case reports of endometriosis recurrence or malignant transformation in women undergoing treatment for menopausal symptoms. We highlight common presenting symptoms, potential risk factors and outcomes amongst the studies. Sparse high-quality evidence was identified, with few observational studies and only two randomized controlled trials. Given this paucity of data, no definitive conclusions can be drawn concerning risk.WIDER IMPLICATIONSDue to the lack of high-quality studies, it remains unclear how to advise women with a history of endometriosis regarding the management of menopausal symptoms. The absolute risk of disease recurrence and malignant transformation cannot be quantified, and the impact of HRT use on these outcomes is not known. Multicentre randomized trials or large observational studies are urgently needed to inform clinicians and patients alike.

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Section: Introductionmentioning

confidence: 99%

The management of menopause in women with a history of endometriosis: a systematic review

Gemmell

Webster

Kirtley

et al. 2017

Human Reproduction Update

101

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“…The need for surgery and histological evaluation is also justified by recent studies indicating an increased risk for malignancy in patients suffering from endometriosis when large or rapidly growing endometriomas are detected or when suspicious changes in sonographic appearance occur [10]. In such cases, repeated ovarian surgeries may result in irreversible damage to the ovary [11,12].…”

Section: Introductionmentioning

confidence: 99%

The role of fertility preservation in patients with endometriosis

Carrillo

Seidman

Cittadini

et al. 2016

J Assist Reprod Genet

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Patients affected with severe endometriosis are at significant risk for ovarian tissue damage, which may lead to infertility, reduced response to ovarian stimulation, and occasionally, premature ovarian failure. The risk for a compromised ovarian reserve in young patients is especially high following repeated surgical intervention and in the presence of bilateral endometriomas. In many cases, enhanced loss of ovarian reserve may also result from the damaging effect of the pathologic process on follicle reservoir even without surgical interventions. Women diagnosed with severe endometriosis and those designated for extensive ovarian surgical intervention are frequently not planning to conceive. In light of recent advances in fertility preservation techniques (FPT), such as oocytes and ovarian tissue freezing, as well as their increasing success rates, we critically evaluate the options for FPT in patients suffering from endometriosis. Personalized counseling should be offered to all patients with endometriosis taking into account age, extent of ovarian involvement, current ovarian reserve, previous and impending surgeries for endometriosis, along with current success rates and possible risks associated with FPT.

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“…This surgical approach can completely remove the lesion, not only it can significantly improve gastrointestinal symptoms and quality of life, 5 reduce the recurrence rate of endometriosis and increase fertility, 6 but also can prevent the possibility of cancer. 7 Postoperative follow-up plans (including whether to use hormone therapy after surgery) should also be developed in coordination with the department of gynaecology, as studies have shown that postoperative hormone therapy can prolong the interval between surgery and the first recurrence. 8…”

Section: Discussionmentioning

confidence: 99%

Endometriosis within the sigmoid colon: A rare cause of bowel obstruction

Zheng¹,

Guo²,

Lin

2020

Pak J Med Sci

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Endometriosis is a common gynecological disease, ectopic endometrium can invade any part of the body, usually in the ovary and uterine sacral ligament, while endometriosis invades the intestinal wall to cause intestinal obstruction is very rare, which easily leads to misdiagnosis. In this case report, we present a case of sigmoid endometriosis with bowel obstruction. Pathological examination is the main basis for the diagnosis of intestinal endometriosis, and the comprehensive treatment of surgery and hormonal therapy is an effective method for the treatment of intestinal endometriosis. doi: https://doi.org/10.12669/pjms.36.6.2525 How to cite this:Long-zhi Z, Jian G, Wei L. Endometriosis within the sigmoid colon: A rare cause of bowel obstruction. Pak J Med Sci. 2020;36(6):---------. doi: https://doi.org/10.12669/pjms.36.6.2525 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Malignant transformation of endometriosis and its clinical significance

Cited by 42 publications

References 3 publications

The management of menopause in women with a history of endometriosis: a systematic review

The management of menopause in women with a history of endometriosis: a systematic review

The role of fertility preservation in patients with endometriosis

Endometriosis within the sigmoid colon: A rare cause of bowel obstruction

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