Review of malignant degeneration arising in an ovarian endometriosic cyst,
deep pelvic or parietal endometriosis lesions. All mural nodule in a endometrioma is not malignant (blood clot,
ectopic endometrial proliferation and borderline Müllerian sero-mucinous tumors). Differential diagnosis of atypical parietal endometriosis remains the sarcomatous or desmoid tumor pathology.
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 women 1 .
Malignant transformation of an endometriotic cyst is rare (0,7-1,6%) and some risk factors (age > 50 years,
endometrioma diameter > 9 cm) are reported 2,3,4,5,6 . Fig. 1 MRI is usually recommanded for characterization a complex...
Findings and procedure details
Review of endometriosis-associated cancers MRI findings and pathologic correlation in: Endometrioma : enhancing mural nodules in an ovarian endometriosic cyst hyperintense on fat-sat T1-weighted images is suspicious,
with or without shading on T2.
Subtraction images can help,
like hyperintensity on DWI with restricted ADC.
Often no adenopathy neither peritoneal carcinomatosis.
Impact of the size of cyst (>10 cm) / mural nodule (>2 cm),
suspicious MRI signal and age (>40-50 yo). Fig. 3 Fig. 4...
Endometriosis-associated ovarian and extra-ovarian cancer is rare,
but it must be recognized in pelvic MRI (whether adnexal,
parietal or deep pelvic endometriosis lesions). Ovarian cancer (frequently endometrioid or clear cell tumors) should be excluded in case of endometrioma > 9 cm in post-menopausal woman (frequently endometrioid or clear cell tumors). Fig. 17 , Fig. 18 Malignant degeneration may also involve extra-ovarian endometriosis (deep pelvic endometriosis or parietal lesions).
MD. email : firstname.lastname@example.org • CHRU Nice,
L'Archet 2 Hospital - Department of Radiology and Multidisciplinary PreNatal Diagnosis Center. 151 Route de Saint-Antoine,
06200 Nice FRANCE +334 92 03 77 77
http://invs.santepubliquefrance.fr//publications/2009/estimation_ cancer_1980_2005/estimation_cancer_1980_2005.pdf Pearce CL and al.
Ovarian Cancer Association Consortium.
Association between endometriosis and risk of histological subtypes of ovarian cancer: a pooled analysis of case-control studies.
Epub 2012 Feb 22. Van Gorp T and al.
Endometriosis and the development of malignant tumours of the pelvis.
A review of...