Malignant transformation of residual endometriosis after hysterectomy: a case series.
OBJECTIVE
To explore the role of long-standing hormone replacement therapy (HRT) in the malignant transformation of endometriosis.


METHODS
Short case series. Three cases of women with pelvic clearance receiving long-standing HRT studied in detail.


METHODS
Teaching hospital in the United Kingdom (Gynaecological Cancer Centre) (Institutional Review Board approval was not obtained as it was not deemed necessary, this being a case series).


METHODS
Women with a history of pelvic clearance for endometriosis and longstanding HRT.


METHODS
HRT.


METHODS
Malignant transformation of endometriosis.


RESULTS
Long-standing HRT in all three women with pelvic clearance for endometriosis resulted in malignant transformation of residual endometriosis many years after the initial surgery. All cases presented with a new pelvic lesion.


CONCLUSIONS
The diagnosis of malignant transformation needs to be considered in women with a history of endometriosis and with long-term HRT use in whom a new pelvic lesion is detected. The risk of malignant transformation in women with endometriosis after pelvic clearance receiving HRT needs to be explored further. Surveillance with CA-125 and imaging in such cases to predict recurrence or malignant transformation needs to be studied further in a research setting.
Department of Gynaeoncology, New Cross Hospital, Wolverhampton, West Midlands, Wolverhampton, United Kingdom. vrnkar@aol.com
Vrunda C
VC
Karanjgaokar
Damian J
DJ
Murphy
Jagbir S
JS
Samra
Christopher H
CH
Mann
D018195:Adenosarcoma / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002471:Cell Transformation, Neoplastic; D003131:Combined Modality Therapy; D016889:Endometrial Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D004715:Endometriosis / Q000473:pathology* / Q000601:surgery*; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D011183:Postoperative Complications / Q000473:pathology; D012186:Retroperitoneal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery
D000970:Antineoplastic Agents