Endometrioid adenocarcinoma with squamous differentiation arising from ureteral endometriosis in a patient with no history of gonadal endometriosis

• Published in: Gynecologic oncology Vol. 99; no. 3; pp. 749 - 752
• Main Authors: Salerno, M.G., Masciullo, V., Naldini, A., Zannoni, G.F., Vellone, V., Scambia, G.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2005
• Subjects: Adenocarcinoma; Carcinoma, Endometrioid - pathology; Carcinoma, Squamous Cell - pathology; Cell Transformation, Neoplastic - pathology; Endometriosis; Endometriosis - pathology; Female; HRT; Humans; Hysterectomy; Middle Aged; Ureter - pathology; Ureteral Neoplasms - pathology; Urinary tract; Adenocarcinoma; Endometriosis; HRT; Urinary tract
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2005.06.056

Malignant transformation may occur in up to 1% of women with endometriosis and only 20% of these cases occur at extragonadal pelvic sites. Similarly, urinary tract endometriosis is rare and occurs in only 1% of all endometriotic lesions. An endometrioid carcinoma with squamous differentiation arising from periureteral endometriosis presented as a pelvic mass encasing the right ureter. The patient had a history of total hysterectomy and bilateral salpingo-oopherectomy 8 years earlier because of bilateral serous benign cysts with right hemorrhagic corpus luteum and uterine fibroids, and has since been under unopposed estrogen replacement therapy for 5 years. This is the second case of a malignancy arising in endometriosis presenting as an obstructive ureteral mass and the first case of a patient with this condition whose endometriosis is not consistent with a gonadal origin. An analysis of the case and related literature is presented together with the discussion of possible pathogenetic mechanisms.