Type:
Educational Exhibit
Keywords:
Pathology, Education and training, Cancer, eLearning, Education, Diagnostic procedure, MR-Functional imaging, MR-Diffusion/Perfusion, MR, Pelvis, Oncology, Genital / Reproductive system female
Authors:
G. Levy1, S. Taieb2, A.-S. Lemaire2, F. Narducci2, E. Leblanc2, L. Ceugnart 3; 1Nice/FR, 2Lille/FR, 3Lille Cedex/FR
DOI:
10.26044/ecr2019/C-3718
Background
Endometriosis is a common benign pathology (affecting about 10% of women) but discussed as a risk factor for epithelial ovarian cancer.
Ovarian cancer is the 7th female cancer (cumulative risk from 0 to 74 years about 1%) and at 5th rank of cancer deaths in women1.
Malignant transformation of an endometriotic cyst is rare (0,7-1,6%) and some risk factors (age > 50 years,
endometrioma diameter > 9 cm) are reported2,3,4,5,6. Fig. 1
MRI is usually recommanded for characterization a complex pelvic mass (adnexal masses MRI scoring system7) and endometriosis follow-up.
Physiopathologically differentiate malignant degeneration from an endometriosis focus and association of an ovarian cancer with endometriosis8.
3 malignant processes associated with endometriosis9 are described : Fig. 2
- epithelial ovarian cancers : endometrioïd adenocarcinoma and clear cell carcinoma are most commun.
- other Müllerian-type tumors : Müllerian-type mucinous borderline tumor (MMBT),
serous borderline tumor (SBT) and low-grade endometrial tumors (LG-ET)
- sarcomas : adenosarcoma and endometrial stromal sarcoma (ESS).
A new epithelial ovarian tumoral group was recognized (World Health Organization Classification of Tumors of the Female Reproductive),
SEROMUCINOUS TUMORS : 10,11,12
- BENIGN (seromucinous cystadenoma,
seromucinous adenofibroma).
- BORDERLINE (atypical proliferative sero-mucinous tumors) : composed of papillary architecture resembling serous tumors but containing endocervical-like mucinous epithelium.
A subset of these arise from preexisting endometrioid carcinoma and are usually limited to borderline or microinvasive carcinoma.
Regrouped Müllerian type (= endocervical-like) mucinous borderline tumor (MMBT) with frequent association with endometriosis or endosalpingiosis,
and Mixed epithelial borderline tumor of Müllerian type (MEBT).
- MALIGNANT (seromucinous carcinoma).