Ovarian endometrioid carcinoma associated with diffuse pulmonary endometriosis: a case report

Endometriosis is generally assumed to be a benign disease, but it shares many characteristics with malignancy, such as invasive and unrestrained growth and a tendency to metastasize and recur. Although not yet fully delineated, there is a relationship between endometriosis and specific types of epithelial ovarian carcinomas (EOC). A case of an endometrioid ovarian carcinoma in a previously hysterectomized postmenopausal woman, associated with diffuse pulmonary endometriosis is presented. After series of diagnostic and therapeutic procedures, a patient was successfully treated with surgery, chemotherapy, and resection of the suspicious pulmonary lesions which led the authors to a final diagnosis. Most likely such patients with endometriosis-associated ovarian cancers represent different types of patients than traditional ones with ovarian cancer and may require a different therapeutic approach.

Ovarian endometrioid carcinoma; Pulmonary endometriosis.

[1] Nezhat F.R., Pejovic T., Reis F.M., Guo S.W.: “The link between endometriosis and ovarian cancer: clinical implications”. Int. J. Gynecol. Cancer, 2014, 24, 623.

[2] Sampson J.A.: “Endometrial carcinoma of the ovary, arising in endometrial tissue in that organ”. Arch. Surg., 1925, 10, 1.

[3] Heidemann L.N., Hartwell D., Heidemann C.H., Jochumsen K.M.: “The relation between endometriosis and ovarian cancer - a review”. Acta Obstet. Gynecol. Scand., 2014, 93, 20.

[4] Pearce C.L., Templeman C., Rossing M.A., Lee A., Near A.M., Webb P.M., et al.: “Association between endometriosis and risk of histological subtypes of ovarian cancer: a pooled analysis of casecontrol studies”. Lancet Oncol., 2012, 13, 385.

[5] Boruban M.C., Jaishuen A., Sirisabya N., Li Y., Zheng H.G., Deavers M.T., Kavanagh J.J.: “Ovarian endometriosis associated with carcinoma and sarcoma: case report”. Eur. J. Gynaecol. Oncol., 2008, 29, 393.

[6] Erzen M., Rakar S., Klancnik B., Syrjänen K.: “Endometriosis-associated ovarian carcinoma (EAOC): an entity distinct from other ovarian carcinomas as suggested by a nested case-control study”. Gynecol Oncol., 2001, 83, 100.

[7] Melin A., Lundholm C., Malki N., Swahn M.L., Sparen P., Bergqvist A.: “Endometriosis as a prognostic factor for cancer survival”. Int. J. Cancer, 2011, 129, 948.

[8] Benoit L., Arnould L., Cheynel N., Diane B., Causeret S., Machado A., et al.: “Malignant extraovarian endometriosis: a review”. Eur. J. Surg. Oncol., 2006, 32, 6. Epub 2005 Nov 11.

[9] Somigliana E., Vigano’ P., Parazzini F., Stoppelli S., Giambattista E., Vercellini P.: “Association between endometriosis and cancer: a comprehensive review and a critical analysis of clinical and epidemiological evidence”. Gynecol. Oncol., 2006, 101, 331.

[10] Viganò P., Somigliana E., Parazzini F., Vercellini P.: “Bias versus causality: interpreting recent evidence of association between endometriosis and ovarian cancer.” Fertil Steril., 2007, 88, 588.

[11] Kobayashi H., Sugimoto H., Onishi S., Nakano K.: “Novel biomarker candidates for the diagnosis of ovarian clear cell carcinoma”. Oncol. Lett., 2015, 10, 612.