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Endometriosis-Associated Ovarian Cancer: A Review of Pathogenesis
Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
* Author to whom correspondence should be addressed.
Received: 30 January 2013; in revised form: 21 February 2013 / Accepted: 26 February 2013 / Published: 6 March 2013
Abstract: Endometriosis is classically defined as the presence of endometrial glands and stroma outside of the endometrial lining and uterine musculature. With an estimated frequency of 5%–10% among women of reproductive age, endometriosis is a common gynecologic disorder. While in itself a benign lesion, endometriosis shares several characteristics with invasive cancer, has been shown to undergo malignant transformation, and has been associated with an increased risk of epithelial ovarian carcinoma (EOC). Numerous epidemiologic studies have shown an increased risk of EOC among women with endometriosis. This is particularly true for women with endometrioid and clear cell ovarian carcinoma. However, the carcinogenic pathways by which endometriosis associated ovarian carcinoma (EAOC) develops remain poorly understood. Current molecular studies have sought to link endometriosis with EAOC through pathways related to oxidative stress, inflammation and hyperestrogenism. In addition, numerous studies have sought to identify an intermediary lesion between endometriosis and EAOC that may allow for the identification of endometriosis at greatest risk for malignant transformation or for the prevention of malignant transformation of this common gynecologic disorder. The objective of the current article is to review the current data regarding the molecular events associated with EAOC development from endometriosis, with a primary focus on malignancies of the endometrioid and clear cell histologic sub-types.
Keywords: endometriosis; epithelial ovarian carcinoma; malignant transformation
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Worley, M.J., Jr.; Welch, W.R.; Berkowitz, R.S.; Ng, S.-W. Endometriosis-Associated Ovarian Cancer: A Review of Pathogenesis. Int. J. Mol. Sci. 2013, 14, 5367-5379.
Worley MJ, Jr, Welch WR, Berkowitz RS, Ng S-W. Endometriosis-Associated Ovarian Cancer: A Review of Pathogenesis. International Journal of Molecular Sciences. 2013; 14(3):5367-5379.
Worley, Michael J., Jr.; Welch, William R.; Berkowitz, Ross S.; Ng, Shu-Wing. 2013. "Endometriosis-Associated Ovarian Cancer: A Review of Pathogenesis." Int. J. Mol. Sci. 14, no. 3: 5367-5379.