Synchronous borderline ovarian tumor with endometrioid endometrial carcinoma - from diagnosis to treatment. A Case study
DOI:
https://doi.org/10.12775/JEHS.2023.40.01.005Keywords
synchronous cancer, borderline ovarian tumor, ovary cancer, endometrioid cancer, uterine cancerAbstract
Introduction
The occurrence of two primary tumors at an interval of no more than two months is called a synchronous tumor. This also applies to female reproductive organs among which synchronous occurrence of ovarian and endometrial cancers is most frequently observed. This phenomenon is observed mainly in young women before menopause. A rare and problematic diagnostic situation is the synchronous co-occurrence of borderline ovarian carcinoma with endometrioid carcinoma of the endometrium. The diagnostic problem and treatment of this combination of cancers are presented in the following case.
Case description:
A 30-year-old female patient presented to the Gynecologic Oncology Department with a suspected malignant lesions of both ovaries. She underwent fertility-sparing surgery with preservation of the left ovary and uterus. Examination of the resected tissues revealed an endometrioid borderline tumor. During the next hospitalization, an excision of uterine polyps was performed, during which no neoplastic lesion of the endometrium was observed. Ultrasound examination, in which the endometrial lesion was also invisible, raised suspicion of cancer recurrence on the left ovary. The patient was scheduled for resection of the left ovary with the recurrence and hysterectomy. The histopathological examination performed confirmed the recurrence on the ovary and showed foci of G1 endometrioid carcinoma of the uterus.
Conclusions
Cases that meet the criteria for synchronous tumor occurrence should be considered. Appropriate diagnosis and selection of radical treatment could affect the curability of patients. Further research on rare combinations of synchronous neoplasms could be helpful in clinical practice.
References
Tanjak P, Suktitipat B, Vorasan N, Juengwiwattanakitti P, Thiengtrong B, Songjang C, Therasakvichya S, Laiteerapong S, Chinswangwatanakul V. Risks and cancer associations of metachronous and synchronous multiple primary cancers: a 25-year retrospective study. BMC Cancer. 2021 Sep 23;21(1):1045. doi: 10.1186/s12885-021-08766-9. PMID: 34556087; PMCID: PMC8461969.
Zhan X, Li L, Wu M, Lang J. The prognosis of stage IA synchronous endometrial endometrioid and ovarian carcinomas. Arch Gynecol Obstet. 2019 Oct;300(4):1045-1052. doi: 10.1007/s00404-019-05288-5. Epub 2019 Sep 14. PMID: 31520260; PMCID: PMC6759754.
Shin W, Park SY, Kang S, Lim MC, Seo SS. How to manage synchronous endometrial and ovarian cancer patients? BMC Cancer. 2021 May 1;21(1):489. doi: 10.1186/s12885-021-08220-w. PMID: 33933018; PMCID: PMC8088669.
Yoneoka Y, Yoshida H, Ishikawa M, Shimizu H, Uehara T, Murakami T, Kato T. Prognostic factors of synchronous endometrial and ovarian endometrioid carcinoma. J Gynecol Oncol. 2019 Jan;30(1):e7. doi: 10.3802/jgo.2019.30.e7. Epub 2018 Sep 17. PMID: 30479091; PMCID: PMC6304406.
Wang Y, Yu M, Yang JX, Cao DY, Zhang Y, Shen K, You Y. [Clinicopathologic and survival analysis of synchronous primary endometrial and ovarian cancer]. Zhonghua Fu Chan Ke Za Zhi. 2018 Dec 25;53(12):816-822. Chinese. doi: 10.3760/cma.j.issn.0529-567x.2018.12.004. PMID: 30585019.
Soliman PT, Slomovitz BM, Broaddus RR, Sun CC, Oh JC, Eifel PJ, Gershenson DM, Lu KH. Synchronous primary cancers of the endometrium and ovary: a single institution review of 84 cases. Gynecol Oncol. 2004 Aug;94(2):456-62. doi: 10.1016/j.ygyno.2004.05.006. PMID: 15297188.
Sozen H, Vatansever D, Iyibozkurt AC, Topuz S, Ozsurmeli M, Salihoglu Y, Guzelbey B, Berkman S. Clinicopathologic and survival analyses of synchronous primary endometrial and epithelial ovarian cancers. J Obstet Gynaecol Res. 2015 Nov;41(11):1813-9. doi: 10.1111/jog.12826. Epub 2015 Sep 14. PMID: 26369625.
Schultheis AM, Ng CK, De Filippo MR, Piscuoglio S, Macedo GS, Gatius S, Perez Mies B, Soslow RA, Lim RS, Viale A, Huberman KH, Palacios JC, Reis-Filho JS, Matias-Guiu X, Weigelt B. Massively Parallel Sequencing-Based Clonality Analysis of Synchronous Endometrioid Endometrial and Ovarian Carcinomas. J Natl Cancer Inst. 2016 Feb 1;108(6):djv427. doi: 10.1093/jnci/djv427. PMID: 26832770; PMCID: PMC4909128.
Yoneoka Y, Yoshida H, Ishikawa M, Shimizu H, Uehara T, Murakami T, Kato T. Prognostic factors of synchronous endometrial and ovarian endometrioid carcinoma. J Gynecol Oncol. 2019 Jan;30(1):e7. doi: 10.3802/jgo.2019.30.e7. Epub 2018 Sep 17. PMID: 30479091; PMCID: PMC6304406
Sethi N, Sharma R, Khunteta N, Vijay MK, Mehrol C, Yadav ML. Synchronous uterine serous carcinoma and ovarian sex cord stromal tumor (thecoma)-A rare first case report. Indian J Pathol Microbiol. 2022 Apr-Jun;65(2):437-439. doi: 10.4103/IJPM.IJPM_1424_20. PMID: 35435389.
Perrone AM, Girolimetti G, Procaccini M, Marchio L, Livi A, Borghese G, Porcelli AM, De Iaco P, Gasparre G. Potential for Mitochondrial DNA Sequencing in the Differential Diagnosis of Gynaecological Malignancies. Int J Mol Sci. 2018 Jul 13;19(7):2048. doi: 10.3390/ijms19072048. PMID: 30011887; PMCID: PMC6073261.
Shimizu M, Yamanaka K, Azumi M, Tomimoto M, Washio K, Takahashi R, Nagamata S, Murata Y, Yamasaki Y, Terai Y. A case of synchronous serous ovarian cancer and uterine serous endometrial intraepithelial carcinoma. J Ovarian Res. 2021 Jun 29;14(1):87. doi: 10.1186/s13048-021-00835-8. PMID: 34187525; PMCID: PMC8244197.
Zhang W, Jia S, Xiang Y, Yang J, Jia C, Leng J. Comparative study of endometrioid borderline ovarian tumor with and without endometriosis. J Ovarian Res. 2018 Aug 11;11(1):67. doi: 10.1186/s13048-018-0440-x. PMID: 30098603; PMCID: PMC6087536.
Nebgen DR, Lu KH, Bast RC Jr. Novel Approaches to Ovarian Cancer Screening. Curr Oncol Rep. 2019 Jul 26;21(8):75. doi: 10.1007/s11912-019-0816-0. PMID: 31346778; PMCID: PMC6662655.
Machida H, Matsuo K, Yamagami W, Ebina Y, Kobayashi Y, Tabata T, Kanauchi M, Nagase S, Enomoto T, Mikami M. Trends and characteristics of epithelial ovarian cancer in Japan between 2002 and 2015: A JSGO-JSOG joint study. Gynecol Oncol. 2019 Jun;153(3):589-596. doi: 10.1016/j.ygyno.2019.03.243. Epub 2019 Mar 21. PMID: 30905436; PMCID: PMC7526703.
Cybulska P, Paula ADC, Tseng J, Leitao MM Jr, Bashashati A, Huntsman DG, Nazeran TM, Aghajanian C, Abu-Rustum NR, DeLair DF, Shah SP, Weigelt B. Molecular profiling and molecular classification of endometrioid ovarian carcinomas. Gynecol Oncol. 2019 Sep;154(3):516-523. doi: 10.1016/j.ygyno.2019.07.012. Epub 2019 Jul 21. PMID: 31340883; PMCID: PMC6736779.
Gilks CB, Kommoss F. Synchronous tumours of the female reproductive tract. Pathology. 2018 Feb;50(2):214-221. doi: 10.1016/j.pathol.2017.10.007. Epub 2017 Dec 14. PMID: 29249564.
Luo ZH, Qi WL, Jin AF, Liao FX, Liu Q, Zeng QY. The role of 18F-FDG PET/CT in patients with synchronous multiple primary malignant neoplasms occurring at the same time. Front Oncol. 2022 Dec 2;12:1068055. doi: 10.3389/fonc.2022.1068055. PMID: 36530987; PMCID: PMC9757168.
Pecorino B, Laganà AS, Chiantera V, Ferrara M, Di Stefano AB, Di Donna MC, Sorrentino F, Nappi L, Mikuš M, Scollo P. Progression Free Survival, Overall Survival, and Relapse Rate in Endometrioid Ovarian Cancer and Synchronous Endometrial-Ovarian Endometrioid Cancer (SEO-EC): Results from a Large Retrospective Analysis. Medicina (Kaunas). 2022 Nov 23;58(12):1706. doi: 10.3390/medicina58121706. PMID: 36556908; PMCID: PMC9784653.
Sakamoto I, Hirotsu Y, Amemiya K, Nozaki T, Mochizuki H, Omata M. Elucidation of genomic origin of synchronous endometrial and ovarian cancer (SEO) by genomic and microsatellite analysis. J Gynecol Oncol. 2023 Jan;34(1):e6. doi: 10.3802/jgo.2023.34.e6. Epub 2022 Oct 6. PMID: 36245225; PMCID: PMC9807354
Moro F, Leombroni M, Pasciuto T, Trivellizzi IN, Mascilini F, Ciccarone F, Zannoni GF, Fanfani F, Scambia G, Testa AC. Synchronous primary cancers of endometrium and ovary vs endometrial cancer with ovarian metastasis: an observational study. Ultrasound Obstet Gynecol. 2019 Jun;53(6):827-835. doi: 10.1002/uog.20213. Epub 2019 May 3. PMID: 30620432.
Amaral PI, Silva A, Lacerda A, Barros C. Synchronous endometrioid endometrial and ovarian cancer in a 34-year-old woman. BMJ Case Rep. 2015 Sep 8;2015:bcr2015210940. doi: 10.1136/bcr-2015-210940. PMID: 26351313; PMCID: PMC4567756.
Treloar SA, Wicks J, Nyholt DR, Montgomery GW, Bahlo M, Smith V, Dawson G, Mackay IJ, Weeks DE, Bennett ST, Carey A, Ewen-White KR, Duffy DL, O'connor DT, Barlow DH, Martin NG, Kennedy SH. Genomewide linkage study in 1,176 affected sister pair families identifies a significant susceptibility locus for endometriosis on chromosome 10q26. Am J Hum Genet. 2005 Sep;77(3):365-76. doi: 10.1086/432960. Epub 2005 Jul 21. PMID: 16080113; PMCID: PMC1226203.
Jia SZ, Zhang JJ, Yang JJ, Xiang Y, Liang Z, Leng JH. Risk of synchronous endometrial disorders in women with endometrioid borderline tumors of the ovary. J Ovarian Res. 2018 Apr 19;11(1):30. doi: 10.1186/s13048-018-0405-0. PMID: 29673382; PMCID: PMC5909205.
Reichenbach J, Schmoeckel E, Mahner S, Trillsch F. Diagnostic workup for endometrioid borderline ovarian tumors (eBOT) requires histopathological evaluation of the uterus. J Ovarian Res. 2021 Jul 7;14(1):89. doi: 10.1186/s13048-021-00839-4. PMID: 34233728; PMCID: PMC8265084.
Uzan C, Berretta R, Rolla M, Gouy S, Fauvet R, Darai E, Duvillard P, Morice P. Management and prognosis of endometrioid borderline tumors of the ovary. Surg Oncol. 2012 Sep;21(3):178-84. doi: 10.1016/j.suronc.2012.02.002. Epub 2012 Mar 13. PMID: 22418038.
14 Song L, Li Q, Yang K, Yin R, Wang D. Three primary synchronous malignancies of the uterus, cervix, and fallopian tube: A case report. Medicine (Baltimore). 2018 Jun;97(24):e11107. doi: 10.1097/MD.0000000000011107. PMID: 29901630; PMCID: PMC6024067.
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