title: Pathogenesis and malignant transformation of adenomyosis (review).
abstract: The aim of our review was to identify the current information with regard             to the pathogenesis and malignant transformation of adenomyosis. The current literature             was reviewed by searching MEDLINE/PubMed, using the following keywords: adenomyosis,             myometrium, stromal cells, malignant transformation, pathogenesis, etiology, genome-wide             and microarray. Early signs of the development of adenomyosis are considered to             be the penetration of stromal cells into the inner layer of the myometrium. Adenomyosis             smooth muscle cells are developed, possibly, through a remodeling pathway via             reactivation of coelomic epithelial cells as a result of estrogen-induced epithelial             mesenchymal transition. Smooth muscle cell hyperplasia and hypertrophy are a reflection             of a reaction of the surrounding tissue. The development of adenocarcinoma arising             from adenomyosis is a relatively rare occurrence. In our literature review, to             date, 44 cases of malignant tumors arising from adenomyosis have been documented.             Studies reporting results of genetic abnormalities, epigenetic changes, monoclonal             expansion, mutational analysis and the inactivation of specific tumor suppressor             genes are very few in this field. In conclusion, adenomyosis can be a precursor             of some carcinomas. The exact molecular mechanisms that lead to the malignant             transformation are poorly understood.
authors.affiliation: Department of Obstetrics and Gynecology, Nara Medical University,                     Kashihara, Nara 634-8522, Japan.
authors.forename: Natsuki
authors.initials: N
authors.lastname: Koike
authors.forename: Taihei
authors.initials: T
authors.lastname: Tsunemi
authors.forename: Chiharu
authors.initials: C
authors.lastname: Uekuri
authors.forename: Juria
authors.initials: J
authors.lastname: Akasaka
authors.forename: Fuminori
authors.initials: F
authors.lastname: Ito
authors.forename: Aiko
authors.initials: A
authors.lastname: Shigemitsu
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kobayashi
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D062788:Adenomyosis / Q000473:pathology*; D000818:Animals; D002471:Cell Transformation, Neoplastic; D004195:Disease Models, Animal; D016889:Endometrial Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D009215:Myometrium / Q000473:pathology