Endometrioid adenocarcinoma presenting in a patient 18 years after hysterectomy: a potential hazard of unopposed oestrogen therapy

Two cases of extragonadal malignant transformation of endometriosis after TAH/BSO for benign indications

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Extragonadal malignant transformation of endometriosis can occur after oophorectomy.

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Endometriosis-associated malignancy can occur in the absence of hormone replacement.

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Estrogen and progesterone receptor status can influence treatment strategies.

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The role of chemotherapy for malignant transformation of endometriosis is not clear.

Malignant transformation of persistent endometriosis after hysterectomy

The malignant transformation of persistent endometriotic implants into endometrioid adenocarcinoma is rare, especially after remote hysterectomy and salpingo-oophorectomy (TAH-BSO), and there are few cases reported in the English language literature. Patients receiving estrogen replacement therapy are common among the reported cases. We present a case that demonstrates the possibility of malignant transformation in a 53-year-old female, known case of endometriosis, who underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy with no evidence of malignancy in the final pathology report. After 9 years, she presented with lower abdominal mass, and histopathological studies confirmed the diagnosis of well-differentiated endometrioid adenocarcinoma. The possibility of malignant transformation and possible risk factors are discussed with a brief literature review.