Clinicopathologic features of ovarian cancer in patients with ovarian endometrioma

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Abstract
Objective:  The purpose of this study was to describe the clinicopathologic features of malignant transformation in patients with ovarian endometrioma, their treatment and outcome in the Kinki region, Japan.Patients and Methods:  Patients meeting Sampson and Scott's criteria for cancer associated with endometriosis were identified by chart review and pathology reports. This retrospective survey describes 18 women with a history of ovarian endometrioma. These cases were followed as benign ovarian endometrioma before malignant transformation on the basis of imaging findings by gynecologic oncologists or radiologists.Results:  Mean age at presentation of malignant transformation was 45.2 years (range, 36–66 years), and 78% (n = 14) were premenopausal women. The pattern of spread was local in 16 (89%), regional in 2 (11%) and distant in 0 (0%). There was a common left‐sided predominance. Characteristic histologic findings were 61% clear cell carcinoma. Endometriosis‐associated malignancies have a favorable prognosis. The patients showed long latency intervals before developing ovarian cancer (mean, 4.5 years; range, 1–16 years). Among them, subjects (n = 10) whose ages are more than 45 years old had shorter latency intervals (mean, 1 year; range, 1–3 years), compared with those (n = 8) aged less than 45 years old (mean, 8.4 years; range, 3–16 years).Conclusion:  Ovarian endometrioma could be viewed as a neoplastic process, particularly in perimenopausal women.

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