Postmenopozal ovarian endometrioma kaynaklı yüksek dereceli over seröz karsinomu: Nadir Görülen Bir Olgu

Abstract

Postmenopozal ovarian endometriomadan kaynaklanan yüksek dereceli seröz over kanseri vakasını sunmayı amaçladık. 64 yaş kadın hasta pelvik ağrı ve vajinal akıntı şikayeti ile kliniğimize başvurdu. Ultrason görüntülemesinde endometrial kalınlaşma ve sol adneksial alanda 37*23 mm kistik kitle saptandı. Operasyon sırasında solid pelvik kitlenin cul-de-sac yerleşimli ve rektum ile sol overi infiltre ettiği görüldü. Frozen incelemede benign sol adneksial kitle, benign lenf nodları ve rektosigmoid kolon ile uterusta kökeni belirsiz adenokarsinoma ait morfolojik bulgular saptandı. Nihai patoloji sonucu iki mikroskopik odakta ovarian endometriomadan kaynaklı yüksek dereceli ovarian seröz kanser olarak geldi. Endometriomadan kaynaklanan epitelyal seröz over kanseri az görülen bir durumdur. Artmış tümör belirteçleri ile birlikte bulunan postmenopozal endometrioma ile karşılaşıldığında olası over kanserine malign dönüşüm olabileceği dikkate alınmalıdır.

Keywords

• endometrioma
• epitelyal seröz over kanser
• postmenapozal adneksal kitle

High-grade serous carcinoma arising in postmenopausal ovarian endometrioma: A rarely encountered case

Abstract

Epithelial ovarian serous cancer arising in endometrioma is an uncommon phenomenon. Here, we present a case of postmenopausal ovarian high-grade serous carcinoma associated with ovarian endometrioma. A 64-year-old woman attended the clinic with pelvic pain and persistent vaginal discharge. Ultrasonography revealed an endometrial thickness and 37*23 mm left cystic adnexal mass. During the operation, solid pelvic mass grossly located in the cul-de-sac infiltrating rectum and left ovarian cysts were observed. At the intraoperative frozen section, benign left adnexal mass, benign pelvic lymph nodes, and the morphological findings of adenocarcinoma with undetermined-site of the origin were detected in the uterus and rectosigmoid colon. Final pathology revealed a high-grade ovarian serous carcinoma arising in ovarian endometrioma from two microscopic focuses. In sum, when we encounter postmenopausal endometrioma with increased biomarkers, it is crucial to consider the possibility of malignant transformation to ovarian cancer.

Keywords

• endometrioma
• ovarian serous cancer
• postmenopausal adnexal mass

References

1. 1. Del Carmen MG, Smith Sehdev AE, Fader AN, Zahurak ML, Richardson M, Fruehauf JP, et al. Endometriosis-associated ovarian carcinoma: differential expression of vascular endothelial growth factor and estrogen/progesterone receptors. Cancer. 2003;98:1658–1663.
2. 2. Kim HS, Kim TH, Chung HH, Song YS. Risk and prognosis of ovarian cancer in women with endometriosis: a meta-analysis. Br J Cancer. 2014;110(7):1878-1890.
3. 3. Sampson JA. Endometrial carcinoma of the ovary arising in endometrial tissue in that organ. Arch Surg. 1925;10:1–72.
4. 4. Heaps JM, Nieberg RK, Berek JS. Malignant neoplasms arising in endometriosis. Obstet Gynecol. 1990;75(6):1023–1028.
5. 5. Lim MC, Chun KC, Shin SJ, Lee IH, Lim KT, Cho CH, et al. Clinical presentation of endometrioid epithelial ovarian cancer with concurrent endometriosis: a multicenter retrospective study. Cancer Epidemiol Biomarkers Prev. 2010;19:398-404.
6. 6. Modesitt SC, Tortolero-Luna G, Robinson JB, Gershenson DM, Wolf JK. Ovarian and extraovarian endometriosis-associated cancer. Obstet Gynecol. 2002;100:788-795.
7. 7. Mangili G, Bergamini A, Taccagni G, Gentile C, Panina P, Viganò P, et al. Unraveling the two entities of endometrioid ovarian cancer: a single center clinical experience. Gynecol Oncol. 2012;126:403–407.
8. 8. Ulrich U, Rhiem K, Kaminski M, Wardelmann E, Trog D, Valter M, et al. Parametrial and rectovaginal adenocarcinoma arising from endometriosis. Int J Gynecol Cancer. 2005;15:1206–1209.