abstract

A case of double malignancy of endometrioid cancer arising from deep
infiltrating endometriosis and endometrial cancer
Abstract ID : 1528
Soumis par : Yoshiaki Ota Le 2016-02-29 07:57:22
Nom de la catégorie : SEUD CONGRESS
Typologie : Video
Statut : validé
Autorisation de diffusion : Yes/Oui
------------------------------------Introduction
The rate of malignant transformation of ovarian endometrioma has been reported to be 0.7% in Japan. On the other
hand, malignant transformation of deep infiltrating endometriosis (DIE) rarely presents symptoms, and it is usually
considered as a metastatic lesion if endometrial cancer coexists. We encountered a case of double malignancy involving
stage IA endometrial cancer and what was considered to be malignant transformation of DIE.
Case
A 42-year-old patient visited another clinic with a complaint of metrorrhagia. She was diagnosed with endometrioid
adenocarcinoma by endometrial biopsy, and referred to our hospital. Tumor invasion was evaluated to involve less than
half of the myometrium on MRI. Furthermore, a contrast-enhanced mass of 2.7x1.3 cm was observed on the proximal
side of the left uterosacral ligament, and peritoneal dissemination or DIE was suspected. The preoperative diagnosis
was endometrial cancer stage IA and DIE. Robot-assisted modified radical hysterectomy and para-aortic and pelvic
lymph node dissection were performed (operative time: 277 minutes, blood loss: 125 g). In addition to adhesion due to
DIE, a papillary mass suspected to be dissemination was observed at the proximal side of the left uterosacral ligament,
and resected. The mass at the uterosacral ligament was diagnosed as an endometrioid adenocarcinoma, surrounded by
an endometriotic lesion. HE staining identified transitional site of malignant transformation. CD10-immunostaining
showed continuation from the endometriotic lesion, and a transitional site of malignant transformation was observed.
Furthermore, P53 immunostaining did not show differences between the lesions. Based on the above, the post-operative
diagnosis was double malignancy of endometrial cancer IA and malignant transformation of DIE.
Discussion
We encountered a case of endometrial cancer derived from the malignant transformation of DIE. At present, the
significance of surgical DIE resection is pain relief, but the prevention of malignant transformation should also be
considered.
------------------------------------Mots clefs : DIE malignant transformation
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Auteurs
YOSHIAKI OTA 1,
1. Obstetrics and Gynecology, Kurashiki Medical Center, Kurashiki, JAPAN
Auteurs (raw format)
OTA YOSHIAKI - email : [email protected] Etablissement : Kurashiki Medical Center Service : Obstetrics and
Gynecology Ville : Kurashiki Pays : JAPAN Présentateur : Oui