A Case of Endometrial Stromal Sarcoma with Synchronous Bilateral Adenocarcinoma of Ovary

Caramelo, Olga; Marinho, C. S.; Rebelo, Teresa; Amaral, Natália; Mota, Fernando; Cunha, Flávia; Torgal, Isabel

doi:10.1155/2012/687510

Cited by 4 publications

(14 citation statements)

References 36 publications

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“…Based on our experience and a review of the available literature, surgical resection is the mainstay of treatment for primary ovarian ESS. Primary surgery for early disease includes hysterectomy and bilateral salpingo-oophorectomy; tumor debulking is reserved for advanced-stage disease [ 1 , 11 , 20 ]. Lymph node metastasis can occur in uterine endometrial stromal sarcomas at a rate of 2% to 45%; however, lymphadenectomy does not seem to improve survival [ 26 , 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…Similar to the treatment for the comparable uterine tumors, adjuvant therapies including radiotherapy, chemotherapy, and hormonal therapy have been used for the management of primary ovarian ESS [ 1 , 4 , 6 , 11 , 20 ]. Low-grade ESS is considered a hormone-dependent malignancy, which means hormonal therapy with high-dose oral progestins, gonadotropin-releasing hormone analogs, and aromatase inhibitors may be effective.…”

Section: Discussionmentioning

confidence: 99%

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Primary endometrioid stromal sarcomas of the ovary: a clinicopathological study of 14 cases with a review of the literature

Xie

Cao

et al. 2017

Oncotarget

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PurposePrimary endometrioid stromal sarcomas (ESS) of the ovary are rare mesenchymal tumors with scarce data on their behavior and optimal treatment. We aimed to describe the clinicopathologic features and outcome among patients with primary ovarian ESS.ResultsThe age of the patients ranged from 34 to 61 years (mean: 49.1 years, median: 51.5 years). The most common symptoms were abdominal distention or pain or both. Nine (64.3%) and five patients (35.7%) had low-grade and high-grade disease, respectively. The median duration of follow-up was 65 months (range, 8–311 months). All 9 patients with low-grade ESS were alive, of these, 3 (33.3%) of them developed recurrence after surgery. Only 1 patient (20%) with high-grade ESS was alive with no evidence of disease in a short-term follow-up visit; the remaining 4 (80%) developed recurrence after surgery, and 2 (40%) died of progressive disease.MethodsMedical records of 14 patients with primary ovarian ESS in our institution were collected and analyzed.ConclusionsThe behavior of primary ovarian ESS is similar to that of their uterine counterparts. Low-grade ESS is an indolent tumor with a propensity for late recurrences. The prognosis of high-grade ESS is poor.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Primary endometrioid stromal sarcomas of the ovary: a clinicopathological study of 14 cases with a review of the literature

Xie

Cao

et al. 2017

Oncotarget

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“…Gene sequencing has shown that approximately 20% of ovarian endometriosis (OE) and deep endometriosis lesions have cancerous somatic driver mutations [17]. Cancer arising with A is very rare, with transformation occurring in only 1% of cases [18][19][20]. The first case of clear cell adenocarcinoma (CACC) and endometrioid carcinoma (EC) resulting from A was reported in 1897 [21].…”

Section: Morphological Characteristics Of Endometriosis and Adenomyosismentioning

confidence: 99%

“…This pathology is rare, with a 1% incidence of cases associated with malignant transformation reported in the literature [18][19][20]. The incidence of these transformations could be influenced by the missing histopathological examination of the whole tumor detected.…”

Section: Microscopic Characteristics Of a And E Local And Glandular F...mentioning

confidence: 99%

Clinical Characteristics and Local Histopathological Modulators of Endometriosis and Its Progression

Istrate-Ofiţeru,

Mogoantă,

Zorilă

et al. 2024

IJMS

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Endometriosis (E) and adenomyosis (A) are associated with a wide spectrum of symptoms and may present various histopathological transformations, such as the presence of hyperplasia, atypia, and malignant transformation occurring under the influence of local inflammatory, vascular and hormonal factors and by the alteration of tumor suppressor proteins and the inhibition of cell apoptosis, with an increased degree of lesion proliferation. Material and methods: This retrospective study included 243 patients from whom tissue with E/A or normal control uterine tissue was harvested and stained by histochemical and classical immunohistochemical staining. We assessed the symptomatology of the patients, the structure of the ectopic epithelium and the presence of neovascularization, hormone receptors, inflammatory cells and oncoproteins involved in lesion development. Atypical areas were analyzed using multiple immunolabeling techniques. Results: The cytokeratin (CK) CK7+/CK20− expression profile was present in E foci and differentiated them from digestive metastases. The neovascularization marker cluster of differentiation (CD) 34+ was increased, especially in areas with malignant transformation of E or A foci. T:CD3+ lymphocytes, B:CD20+ lymphocytes, CD68+ macrophages and tryptase+ mast cells were abundant, especially in cases associated with malignant transformation, being markers of the proinflammatory microenvironment. In addition, we found a significantly increased cell division index (Ki67+), with transformation and inactivation of tumor suppressor genes p53, B-cell lymphoma 2 (BCL-2) and Phosphatase and tensin homolog (PTEN) in areas with E/A-transformed malignancy. Conclusions: Proinflammatory/vascular/hormonal changes trigger E/A progression and the onset of cellular atypia and malignant transformation, exacerbating symptoms, especially local pain and vaginal bleeding. These triggers may represent future therapeutic targets.

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“…Cancer arising from adenomyosis is very rare, with transformation occurring in only 1% of cases [4,5,9] and in older individuals [10]. The first case of clear cell and endometrioid carcinoma arising from adenomyosis was described in 1897 [3].…”

Section: Introductionmentioning

confidence: 99%

Adenomyosis and Its Possible Malignancy: A Review of the Literature

et al. 2023

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Cancer arising from adenomyosis is very rare, with transformation occurring in only 1% of cases and in older individuals. Adenomyosis, endometriosis and cancers may share a common pathogenic mechanism that includes hormonal factors, genetic predisposition, growth factors, inflammation, immune system dysregulation, environmental factors and oxidative stress. Endometriosis and adenomyosis both exhibit malignant behaviour. The most common risk factor for malignant transformation is prolonged exposure to oestrogens. The golden standard for diagnosis is histopathology. Colman and Rosenthal emphasised the most important characteristics in adenomyosis-associated cancer. Kumar and Anderson emphasised the importance of demonstrating a transition between benign and malignant endometrial glands in cancer arising from adenomyosis. As it is very rare, it is difficult to standardize treatment. In this manuscript, we try to emphasize some aspects regarding the management strategy, as well as how heterogenous the studies from the literature are in terms of prognosis in both cancers that develop from adenomyosis or those that are only associated with adenomyosis. The pathogenic mechanisms of transformation remain unclear. As these types of cancer are so rare, there is no standardised treatment. A novel target in the diagnosis and treatment of gynaecological malignancies associated with adenomyosis is also being studied for the development of new therapeutic concepts.

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A Case of Endometrial Stromal Sarcoma with Synchronous Bilateral Adenocarcinoma of Ovary

Cited by 4 publications

References 36 publications

Primary endometrioid stromal sarcomas of the ovary: a clinicopathological study of 14 cases with a review of the literature

Primary endometrioid stromal sarcomas of the ovary: a clinicopathological study of 14 cases with a review of the literature

Clinical Characteristics and Local Histopathological Modulators of Endometriosis and Its Progression

Adenomyosis and Its Possible Malignancy: A Review of the Literature

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