Simultaneous occurrence of two distinct histotypes of ovarian endometriosis-associated cancer in bilateral ovaries: implications for monoclonal histogenesis from a case report

BackgroundTransformation of endometriosis to malignancy is a rare occurrence. Clear cell ovarian cancer and endometrioid ovarian cancer are the two histotypes most consistently linked to endometriosis. The exact pathways leading to malignant transformation of endometriosis remain elusive.Case presen...

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Main Authors: Luyang Zhao, Yunyue Liu, Feng Liu, Xiangshu Jin, Jia Xu, Shuting Zhou, Yuanguang Meng, Aijun Liu, Weng Yang
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-11-01
Series:Frontiers in Oncology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2023.1280529/full
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author Luyang Zhao
Yunyue Liu
Feng Liu
Xiangshu Jin
Jia Xu
Shuting Zhou
Yuanguang Meng
Aijun Liu
Weng Yang
author_facet Luyang Zhao
Yunyue Liu
Feng Liu
Xiangshu Jin
Jia Xu
Shuting Zhou
Yuanguang Meng
Aijun Liu
Weng Yang
author_sort Luyang Zhao
collection DOAJ
description BackgroundTransformation of endometriosis to malignancy is a rare occurrence. Clear cell ovarian cancer and endometrioid ovarian cancer are the two histotypes most consistently linked to endometriosis. The exact pathways leading to malignant transformation of endometriosis remain elusive.Case presentationA 41-year-old woman presented to our hospital with a ten days history of abdominal pain which was not responsive to medication. Pathological examination revealed an unexpected finding of bilateral endometriosis associated with distinct malignancies: a clear cell carcinoma in the right ovary and a well-differentiated endometrioid carcinoma in the left ovary. Molecular analysis indicated a shared somatic driver mutation in ING1 in the eutopic endometrium and the bilateral ovaries while simultaneously exhibiting specific genetic alterations unique to each carcinoma. Notably, several common mutation sites were also identified, including previously reported common oncogenes (KRAS, PIK3CA, ARID1A). This finding prompts the hypothesis of a possible monoclonal origin of the two tumours.ConclusionThis case represents an exceedingly rare occurrence of two different histotypes of ovarian endometriosis-associated cancer manifesting simultaneously in bilateral ovaries. Based on genetic analysis, we hypothesize that these malignancies may have a monoclonal origin, providing insights into understanding the different biological mechanisms underlying carcinogenesis.
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spelling doaj.art-ba825e4ca555459283afcca1f15fc54b2023-11-27T06:14:21ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-11-011310.3389/fonc.2023.12805291280529Simultaneous occurrence of two distinct histotypes of ovarian endometriosis-associated cancer in bilateral ovaries: implications for monoclonal histogenesis from a case reportLuyang Zhao0Yunyue Liu1Feng Liu2Xiangshu Jin3Jia Xu4Shuting Zhou5Yuanguang Meng6Aijun Liu7Weng Yang8Department of Obstetrics and Gynecology, The Seventh Medical Centre of Chinese People’s Liberation Army General Hospital, Beijing, ChinaDepartment of Obstetrics and Gynecology, The Seventh Medical Centre of Chinese People’s Liberation Army General Hospital, Beijing, ChinaDepartment of Obstetrics and Gynecology, The Seventh Medical Centre of Chinese People’s Liberation Army General Hospital, Beijing, ChinaDepartment of Obstetrics and Gynecology, The Seventh Medical Centre of Chinese People’s Liberation Army General Hospital, Beijing, ChinaDepartment of Obstetrics and Gynecology, The Seventh Medical Centre of Chinese People’s Liberation Army General Hospital, Beijing, ChinaDepartment of Obstetrics and Gynecology, The Seventh Medical Centre of Chinese People’s Liberation Army General Hospital, Beijing, ChinaDepartment of Obstetrics and Gynecology, The Seventh Medical Centre of Chinese People’s Liberation Army General Hospital, Beijing, ChinaDepartment of Pathology, The Seventh Medical Centre of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, ChinaDepartment of Obstetrics and Gynecology, The Seventh Medical Centre of Chinese People’s Liberation Army General Hospital, Beijing, ChinaBackgroundTransformation of endometriosis to malignancy is a rare occurrence. Clear cell ovarian cancer and endometrioid ovarian cancer are the two histotypes most consistently linked to endometriosis. The exact pathways leading to malignant transformation of endometriosis remain elusive.Case presentationA 41-year-old woman presented to our hospital with a ten days history of abdominal pain which was not responsive to medication. Pathological examination revealed an unexpected finding of bilateral endometriosis associated with distinct malignancies: a clear cell carcinoma in the right ovary and a well-differentiated endometrioid carcinoma in the left ovary. Molecular analysis indicated a shared somatic driver mutation in ING1 in the eutopic endometrium and the bilateral ovaries while simultaneously exhibiting specific genetic alterations unique to each carcinoma. Notably, several common mutation sites were also identified, including previously reported common oncogenes (KRAS, PIK3CA, ARID1A). This finding prompts the hypothesis of a possible monoclonal origin of the two tumours.ConclusionThis case represents an exceedingly rare occurrence of two different histotypes of ovarian endometriosis-associated cancer manifesting simultaneously in bilateral ovaries. Based on genetic analysis, we hypothesize that these malignancies may have a monoclonal origin, providing insights into understanding the different biological mechanisms underlying carcinogenesis.https://www.frontiersin.org/articles/10.3389/fonc.2023.1280529/fullendometriosis-associated ovarian cancerclear cell ovarian cancerendometrioid ovarian cancerendometriosiseutopic endometrium
spellingShingle Luyang Zhao
Yunyue Liu
Feng Liu
Xiangshu Jin
Jia Xu
Shuting Zhou
Yuanguang Meng
Aijun Liu
Weng Yang
Simultaneous occurrence of two distinct histotypes of ovarian endometriosis-associated cancer in bilateral ovaries: implications for monoclonal histogenesis from a case report
Frontiers in Oncology
endometriosis-associated ovarian cancer
clear cell ovarian cancer
endometrioid ovarian cancer
endometriosis
eutopic endometrium
title Simultaneous occurrence of two distinct histotypes of ovarian endometriosis-associated cancer in bilateral ovaries: implications for monoclonal histogenesis from a case report
title_full Simultaneous occurrence of two distinct histotypes of ovarian endometriosis-associated cancer in bilateral ovaries: implications for monoclonal histogenesis from a case report
title_fullStr Simultaneous occurrence of two distinct histotypes of ovarian endometriosis-associated cancer in bilateral ovaries: implications for monoclonal histogenesis from a case report
title_full_unstemmed Simultaneous occurrence of two distinct histotypes of ovarian endometriosis-associated cancer in bilateral ovaries: implications for monoclonal histogenesis from a case report
title_short Simultaneous occurrence of two distinct histotypes of ovarian endometriosis-associated cancer in bilateral ovaries: implications for monoclonal histogenesis from a case report
title_sort simultaneous occurrence of two distinct histotypes of ovarian endometriosis associated cancer in bilateral ovaries implications for monoclonal histogenesis from a case report
topic endometriosis-associated ovarian cancer
clear cell ovarian cancer
endometrioid ovarian cancer
endometriosis
eutopic endometrium
url https://www.frontiersin.org/articles/10.3389/fonc.2023.1280529/full
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