Ovarian Endometriosis Associated with Ovarian Carcinoma: A Clinicopathological and Immunohistochemical Study

Ogawa, Shinji; Kaku, Tsunehisa; Amada, Satoshi; Kobayashi, Hiroaki; Hirakawa, Tsubasa; Ariyoshi, Kazuya; Kamura, Toshiharu; Nakano, Hitoo

doi:10.1006/gyno.2000.5765

Cited by 241 publications

(178 citation statements)

References 32 publications

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“…If there were no association between cancer and endometriosis then the incidence of endometriosis in women with ovarian cancer would be similar to that in the general population. However, the incidence of endometriosis in women with ovarian cancer is 8 -30% (Fukunaga et al 1997, Ogawa et al 2000, Oral et al 2003. This compares with a background incidence of endometriosis of 7 -15% in women of reproductive age, and less than 2% in postmenopausal women (Lapp 2000).…”

Section: Ovarian Malignancy May Arise Directly From Ovarian Endometrimentioning

confidence: 99%

“…Atypical endometriosis is characterised histologically by endometrial glands with cytological or architectural atypia (LaGrenade & Silverberg 1988), and has been observed in 12 -35% of ovarian endometriosis (Seidman 1996, Bayramoglu & Duzcan 2001. Around 60 -80% of cases of endometriosis-associated ovarian cancer (EAOC) occur in the presence of atypical ovarian endometriosis (Fukunaga et al 1997, Ogawa et al 2000, Oral et al 2003. Of these cases, 25% show direct continuity of the atypical ovarian endometriosis with ovarian cancer (Fukunaga et al 1997), underlying a potential 'premalignant' transition spectrum of non-atypical to atypical and malignant variants.…”

Section: Histopathologymentioning

confidence: 99%

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Endometriosis and the neoplastic process

Varma¹,

Rollason²,

Gupta³

et al. 2004

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Endometriosis is a frequent disorder that commonly presents with infertility and pelvic pain. Although the precise aetiology of endometriosis is unclear, it is generally considered to involve multiple genetic, environmental, immunological, angiogenic and endocrine processes. Genetic factors have been implicated in endometriosis but the susceptibility genes remain largely unknown. Although endometriosis is a benign disorder, recent studies of endometriosis suggest endometriosis could be viewed as a neoplastic process. Evidence to support this hypothesis includes the increased susceptibility to develop ovarian clear-cell and endometrioid cancers in the presence of endometriosis, and molecular similarities between endometriosis and cancer. In this article we discuss (i) the evidence suggesting that endometriosis might be viewed as a neoplastic process, and (ii) the implications of this hypothesis for elucidating the pathogenesis of endometriosis and developing novel methods of diagnostic classification and individualised treatments.

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Section: Ovarian Malignancy May Arise Directly From Ovarian Endometrimentioning

confidence: 99%

Section: Histopathologymentioning

confidence: 99%

Endometriosis and the neoplastic process

Varma¹,

Rollason²,

Gupta³

et al. 2004

Reproduction

184

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“…10 In fact, clear cell adenocarcinomas are closely associated with endometriosis, 11,12 and sequential changes from endometriosis to clear cell adenocarcinoma have been reported. 13 Clinically, patients with clear cell adenocarcinoma have a poor prognosis due to the poor response of the tumor to conventional platinum-or taxane-based chemotherapy. 5,12,14 Therefore, alternative therapeutic options for ovarian clear cell adenocarcinoma are warranted as an additive modality.…”

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confidence: 99%

Glypican-3 expression in clear cell adenocarcinoma of the ovary

et al. 2009

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Glypican-3 is a heparan sulfate proteoglycan that is overexpressed in various neoplasms such as hepatocellular carcinoma, malignant melanoma, and testicular yolk sac tumor. Glypican-3 is currently regarded as a tumor marker and potential target for immunotherapy. To clarify the significance of glypican-3 expression in ovarian clear cell adenocarcinoma, we evaluated glypican-3 expression by immunohistochemistry in nonneoplastic and neoplastic ovaries, and other Mü llerian duct derivatives including endometrium in different menstrual phases. Among the benign lesions examined, glypican-3 expression was identified exclusively in the endometrial epithelium in the gestational period. A total of 213 cases of ovarian adenocarcinoma, including 94 clear cell adenocarcinomas, were studied. Glypican-3 expression was observed in 44% of clear cell adenocarcinomas, whereas it was rarely observed in other histological subtypes: mucinous (4%), endometrioid (5%), and serous (11%; Po0.0001). All six ovarian yolk sac tumors showed diffuse immunoreactivity for glypican-3. In cases of clear cell adenocarcinoma, no correlations were found between glypican-3 expression and clinicopathological factors, such as tumor stage, lymph node metastasis, peritoneal dissemination, and death rate. However, glypican-3 expression was significantly associated with poor overall survival in stage III/IV clear cell adenocarcinoma cases. Our results suggest that overexpression of glypican-3 may be related to the development and aggressive behavior of ovarian clear cell adenocarcinoma.

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“…Moreover, the authors described 29 cases of atypical endometriosis in this cohort and demonstrated evidence for the transition from atypical endometriosis to carcinoma in 23 cases. 21 Another study reported an endometriosis rate of 37% in a large series of 221 patients with endometrioid ovarian carcinomas. 23 Epidemiological data indicates an early onset of endometriosis-associated ovarian carcinomas such as ovarian clear cell carcinomas and endometrioid ovarian carcinomas.…”

Section: Discussionmentioning

confidence: 98%

Loss of ARID1A/BAF250a-expression in endometriosis: a biomarker for risk of carcinogenic transformation?

Samartzis

Noske

et al. 2012

Modern Pathology

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Mutations of the tumor-suppressor gene ARID1A result in the loss of protein expression of the BRG-associated factor 250a (BAF250a), a large subunit of transcription-regulating Human SWI/SNF complexes, which have an important role in the control of cell proliferation and tumor suppression. ARID1A mutations are particularly frequent in endometriosis-associated ovarian clear cell and endometrioid carcinomas, and were recently described as a possible key mechanism and early step in the transformation of endometriosis into cancer. Here, we examined the immunohistochemical expression pattern of BAF250a in a tissue microarray including 74 endometriosis and 30 endometrium samples. Ovarian cancer samples (n ¼ 136) served as a control. Epithelial BAF250a expression was assessable in 90/104 (87%) and stromal BAF250a expression in 95/104 (91%) of the endometriosis, and endometrium cases due to lack of adequate tissue in some spots. Complete lack of BAF250a expression was observed in three endometriomas (n ¼ 3/20, 15%) and one deep-infiltrating endometriosis sample (n ¼ 1/22, 5%), but in none of the peritoneal endometriosis (n ¼ 0/16) and eutopic endometrium samples (n ¼ 0/30). A comparison of the mean immunoreactivity scores revealed a significantly lower expression rate of BAF250a in endometriomas compared with normal endometrium (Po0.0005), as well as peritoneal (P ¼ 0.003) and deep-infiltrating endometriosis (P ¼ 0.02). Our data demonstrates that a complete loss of BAF250a expression is observable in some endometriotic lesions, especially in endometriomas. In addition, we report that a partial loss of BAF250a expression is occurring in the form of cell clusters indicating a clonal loss of BAF250a expression in these cells. The loss of expression of the tumor-suppressor protein BAF250a in some endometriomas possibly indicates a risk of malignant transformation in these cases, which could be of importance in the determination of individual treatment strategies. However, its role and value as a prognostic parameter in endometriosis needs to be further studied.

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Ovarian Endometriosis Associated with Ovarian Carcinoma: A Clinicopathological and Immunohistochemical Study

Cited by 241 publications

References 32 publications

Endometriosis and the neoplastic process

Endometriosis and the neoplastic process

Glypican-3 expression in clear cell adenocarcinoma of the ovary

Loss of ARID1A/BAF250a-expression in endometriosis: a biomarker for risk of carcinogenic transformation?

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