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Author Cuff, J.; Longacre, T.A.
Title Endometriosis does not confer improved prognosis in ovarian carcinoma of uniform cell type Type Journal Article
Year 2012 Publication The American Journal of Surgical Pathology Abbreviated Journal Am J Surg Pathol
Volume 36 Issue 5 Pages 688-695
Keywords Adenocarcinoma, Clear Cell/*complications/mortality/pathology; Adult; Age Factors; Aged; Carcinoma, Endometrioid/*complications/mortality/pathology; Disease Progression; Disease-Free Survival; Endometriosis/*complications; Female; Follow-Up Studies; Humans; Middle Aged; Neoplasm Staging; Neoplasms, Multiple Primary; Ovarian Neoplasms/*complications/mortality/pathology; Prognosis; Survival Analysis
Abstract The role of endometriosis in ovarian cancer, disease progression, and survival is a subject of active investigation. A series of 144 ovarian cancers with clear cell or endometrioid histology or associated endometriosis, all classified on the basis of strict histologic criteria, was evaluated to further explore the relationship between endometriosis-associated ovarian cancer and age at presentation, FIGO stage, histology, presence of synchronous primary disease elsewhere in the mullerian tract, and survival. Patients with endometrioid carcinomas were significantly younger (mean, 52 y) in comparison with patients with either clear cell carcinoma (mean, 55 y) or mixed tumors (mean, 59 y; P=0.002). Clear cell carcinoma presented as low-stage disease (FIGO I) in 33% of cases compared with endometrioid carcinomas in 97% of cases and mixed carcinomas in 27% of cases. Endometriosis was associated with 53% of clear cell carcinomas, 33% of endometrioid carcinomas, and 45% of mixed tumors (P<0.001). Synchronous primary tumors, observed in 31% of endometrioid tumors, 5% of mixed tumors, and in 2% of clear cell tumors (P<0.001), were unlikely to be associated with endometriosis (P=0.04). Univariate analysis of the aggregate cohort demonstrated that the single best overall predictor of disease-free survival was FIGO stage at presentation (P<0.001), followed by histologic subtype (P=0.003). Endometriosis did not have a significant relationship with disease-free survival (P=0.7). We conclude that the link between endometriosis and ovarian cancer is much stronger for clear cell carcinoma than for other histologic subtypes (P<0.001). Furthermore, when uniform histologic criteria are applied, true mixed endometrioid and clear cell carcinomas are uncommon; most endometriosis-associated mixed tumors are heterogenous mixtures of endometrioid, mucinous, and serous histology with areas of clear cell cytoplasm. Endometriosis per se does not appear to predict prognosis in clear cell and endometrioid tumors, with the possible exception of tumors with mixed histology. Until more data are collected, pathologists should classify ovarian tumors with mixed histology as a separate and potentially unique biological and prognostic group.
Address Department of Surgical Pathology, Stanford University School of Medicine, CA 94305, USA. longacre@stanford.edu
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0147-5185 ISBN Medium
Area Expedition Conference
Notes PMID:22498820 Approved no
Call Number (up) ref @ user @ Serial 54018
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Author Terada, T.
Title No evidence of endometriosis within serous and mucinous tumors of the ovary Type Journal Article
Year 2012 Publication International Journal of Clinical and Experimental Pathology Abbreviated Journal Int J Clin Exp Pathol
Volume 5 Issue 2 Pages 140-142
Keywords Adenocarcinoma, Mucinous/complications/*pathology; Cell Transformation, Neoplastic/*pathology; Cystadenocarcinoma, Serous/complications/*pathology; Disease Progression; Endometriosis/complications/*pathology; Female; Humans; Ovarian Neoplasms/complications/*pathology; Retrospective Studies; Ovary tumor; endometriosis; endometriosis-derived tumor; ovary mucinous tumor; ovary serous tumor
Abstract Ovarian endometriosis can transform into malignant tumors. The author retrospectively examined HE slides of 112 serous tumors and 75 mucinous tumors for the existence of ovarian endometriosis. When endometriosis is present within the tumors, the term “endometriosis-derived tumor” was applied. When endometriosis is recognized adjacent to the tumor, the term “endometriosis-associated tumor” was used. Of the 112 serous tumors (46 benign, 18 borderline, and 50 malignant), 4 (3.5%) (2 benign and 2 malignant) were endometriosis-associated tumors. None was endometriosis-derived tumor. Of the 75 mucinous tumors (30 benign, 26 borderline, and 19 malignant), 4 (5%) (1 borderline and 3 benign) were endometriosis-associated tumors. No tumors showed endometriosis-derived tumors. The data suggest that endometriosis does not transform into serous and mucous tumors. The author felt the limitation of retrospective survey, because the limited numbers of slides (5 to 15) were obtained from each tumor. The author also felt that endometriosis can be difficult to discern because of degenerative changes and other similar lesions such as fallopian tube, fimbria, inclusion cysts, rete ovarii, paraovarian cyst, and Mullerian ducts remnants. Prospective study using whole ovarian examination is required.
Address Department of Pathology, Shizuoka City Shimizu Hospital, Shizuoka, Japan. piyo0111jp@yahoo.co.jp
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 1936-2625 ISBN Medium
Area Expedition Conference
Notes PMID:22400074 Approved no
Call Number (up) ref @ user @ Serial 54019
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Author Sundaralingam, A.
Title Endometriosis is associated with an increased risk of ovarian cancer, study shows Type News
Year 2012 Publication BMJ (Clinical Research ed.) Abbreviated Journal Bmj
Volume 344 Issue Pages e1363
Keywords Adenocarcinoma, Clear Cell/epidemiology; Comorbidity; Endometriosis/*epidemiology; Female; Humans; Ovarian Neoplasms/*epidemiology; Risk Factors
Abstract
Address
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0959-535X ISBN Medium
Area Expedition Conference
Notes PMID:22368285 Approved no
Call Number (up) ref @ user @ Serial 54020
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Author Shang, H.S.; Chao, T.K.; Wu, G.Z.; Yu, C.P.
Title A rare case of the coexistence of ovarian clear cell carcinoma, mucinous cystadenoma, and endometriosis in the same ovary Type Journal Article
Year 2011 Publication European Journal of Gynaecological Oncology Abbreviated Journal Eur J Gynaecol Oncol
Volume 32 Issue 6 Pages 677-679
Keywords Adenocarcinoma, Clear Cell/etiology/*pathology; Cystadenoma, Mucinous/complications/*pathology; Endometriosis/complications/*pathology; Female; Humans; Middle Aged; Ovarian Diseases/*pathology; Ovarian Neoplasms/etiology/*pathology
Abstract Clear cell carcinomas and endometrioid carcinomas are associated with endometriosis. The association of clear cell carcinomas with mucinous lesions has only been reported infrequently, and with mucinous cystadenoma has been rarely reported. This is the second reported case of the coexistence of ovarian clear cell carcinoma, mucinous cystadenoma, and endometriosis in the same ovary. A 57-year-old woman presented with lower abdominal pain for three weeks. Ultrasonography revealed a 16 x 14 x 10 cm mass in the left ovary with solid and cystic components. Hysterectomy and bilateral salpingo-oophorectomy were performed. Histopathological examination of the left ovary revealed the presence of clear cell carcinoma, mucinous cystadenoma, and endometriosis. Continuity between the areas of mucinous epithelium and clear cell carcinoma were noted; this may suggest that clear cell carcinoma may arise from endometriosis or mucinous cystic tumors.
Address Department of Pathology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0392-2936 ISBN Medium
Area Expedition Conference
Notes PMID:22335035 Approved no
Call Number (up) ref @ user @ Serial 54021
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Author Stewart, C.J.R.; Leung, Y.; Walsh, M.D.; Walters, R.J.; Young, J.P.; Buchanan, D.D.
Title KRAS mutations in ovarian low-grade endometrioid adenocarcinoma: association with concurrent endometriosis Type Journal Article
Year 2012 Publication Human Pathology Abbreviated Journal Hum Pathol
Volume 43 Issue 8 Pages 1177-1183
Keywords Adult; Aged; Aged, 80 and over; Carcinoma, Endometrioid/complications/*genetics/pathology; DNA Mutational Analysis; Endometriosis/complications/*genetics/pathology; Female; Humans; Middle Aged; Ovarian Neoplasms/complications/*genetics/pathology; Proto-Oncogene Proteins/*genetics; Proto-Oncogene Proteins B-raf/genetics; ras Proteins/*genetics
Abstract The association between ovarian endometrioid adenocarcinoma and endometriosis is well established. However, not all endometrioid adenocarcinomas are directly related to endometriosis, and it has been suggested that there may be clinicopathologic differences between endometriosis-positive and endometriosis-negative tumors. Molecular alterations in endometrioid adenocarcinoma include KRAS and BRAF mutations, but the incidence of these abnormalities in previous reports has been highly variable (0%-36% and 0%-24%, respectively). This may be explained by relatively small sample sizes in earlier studies but could also reflect difficulties in accurately classifying high-grade ovarian malignancies. In the current study, we investigated KRAS and BRAF mutations in 78 low-grade (FIGO grade 1 and 2) endometrioid adenocarcinomas and compared the results with the presence of endometriosis in the tumor-associated ovary and/or in other pelvic sites. KRAS mutations were identified in 12 (29%) of 42 endometriosis-associated endometrioid adenocarcinomas with satisfactory analysis but in only 1 (3%) of 29 tumors in which endometriosis was not identified. BRAF mutation was identified only in a single endometriosis-associated case. These findings support the hypothesis that endometriosis-associated and independent endometrioid adenocarcinoma may develop via different molecular pathways and that KRAS mutations have an important role only in the former tumors. In contrast, BRAF mutations do not appear to have a significant role in either endometrioid adenocarcinoma subgroup. This may be relevant to future targeted therapies in patients with high-stage or recurrent disease and indicate that histopathologists should carefully examine endometrioid adenocarcinoma specimens, including nonneoplastic tissues, for the presence of endometriosis.
Address Department of Histopathology, King Edward Memorial Hospital, Perth 6008, Western Australia. colin.stewart@health.wa.gov.au
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0046-8177 ISBN Medium
Area Expedition Conference
Notes PMID:22305241 Approved no
Call Number (up) ref @ user @ Serial 54022
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