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Ovarian Endometriosis and Clear Cell Carcinoma, Leiomyomatosis Peritonealis Disseminata, and Endometrial Adenocarcinoma: An Unusual, Pathogenetically Related Association

Guarch, Rosa M.D.; Puras, Ana M.D.; Ceres, Rafael M.D.; Isaac, M. Alejandra M.D.; Nogales, Francisco F. M.D.

International Journal of Gynecological Pathology: July 2001 - Volume 20 - Issue 3 - p 267-270
Case Reports

A 42 year-old female with a preoperative clinical diagnosis of ovarian cancer underwent laparotomy which revealed leiomyomatosis peritonealis disseminata (LPD) in the peritoneum and omentum and a left ovarian endometriotic cyst associated with a clear cell carcinoma. A grade 1, superficially invasive villoglandular endometrial endometrioid adenocarcinoma was also found. Microscopically, the endometriotic cyst wall contained an extensive peripheral band-like condensation of stromal cells. These cells were strongly positive for alpha inhibin and may have been the hormonal source responsible for the induction of the simultaneous LPD and endometrial adenocarcinoma. It is proposed that endometriosis is not only a precursor of clear cell carcinoma but, through secondary hormonal induction of the surrounding ovarian stroma, may also provide a hormonal stimulus for diverse proliferative processes.

From the Departments of Pathology and Gynecology (R.G., A.P., R.C.), Hospital Virgen del Camino, Pamplona, and the Department of Pathology (M.A.I., F.F.N.), University Hospital, Granada, Spain.

Address correspondence and reprint requests to Rosa Guarch, M.D., Departamento de Anatomía Patológica, Hospital Virgen del Camino, C/ Irunlarrea 4, 31008 Pamplona, Spain.

© 2001 Lippincott Williams & Wilkins, Inc.