Incidence of synchronous primary neoplasms of the female reproductive tract in women with ovarian endometriosis: a retrospective analysis of 811 cases]

Although endometriosis is a benign disorder recent studies suggest endometriosis could be viewed as a neoplastic process. Objective of this study is to explore the epidemiology of synchronous neoplasms (SPN) in women with severe endometriosis.The prevalence of SPN in cases with endometriotic ovarian cysts that underwent surgery at "Lito" Maternity hospital of Athens and at Anticancer Institute of Sophia was investigated. The review period was 2000 through 2009. The medical records and pathology were reviewed to confirm the diagnosis and stage of tumors.5 women with synchronous cancers of the genital tract were identified. All of our patients had a grade-I endometrioid carcinoma of the uterus (Ia in 3, Ib in 2). Myometrium was invaded less than 1/3 in 4 cases and less than 1/2 in one. Similarly, 4 out of 5 ovarian cancers were endometrioid, while one was serum cystadenosarcoma. All of the ovarian malignancies were grade I (Ib in 3 and Ia in 2). Median diameter of the ovarian neoplasias was 4.3 cm, in contradiction to 4.5 cm that was the median diameter of all endometrioid cysts. When only the larger ovarian malignant cyst in each patient was accounted, then median diameter was calculated as 5.8 cm.Women with synchronous primary cancers of the endometrium and ovary have distinct clinical characteristics including younger age, premenopausal status, and nulliparity. This suggests that a hormonal "field effect" may account for the development of these simultaneous endometrioid cancers, supporting the theory of estrogen receptors.