title: Synchronous Endometrial and Ovarian Carcinomas: Evidence of Clonality.
abstract: Many women with ovarian endometrioid carcinoma present with concurrent endometrial carcinoma. Organ-confined and low-grade synchronous endometrial and ovarian tumors (SEOs) clinically behave as independent primary tumors rather than a single advanced-stage carcinoma. We used 18 SEOs to investigate the ancestral relationship between the endometrial and ovarian components. Based on both targeted and exome sequencing, 17 of 18 patient cases of simultaneous cancer of the endometrium and ovary from our series showed evidence of a clonal relationship, ie, primary tumor and metastasis. Eleven patient cases fulfilled clinicopathological criteria that would lead to classification as independent endometrial and ovarian primary carcinomas, including being of FIGO stage T1a/1A, with organ-restricted growth and without surface involvement; 10 of 11 of these cases showed evidence of clonality. Our observations suggest that the disseminating cells amongst SEOs are restricted to physically accessible and microenvironment-compatible sites yet remain indolent, without the capacity for further dissemination.
authors.affiliation: Department of Pathology and Laboratory Medicine, (MSA, HMH, JS, HLC, ANK, BSS, MKM, CBG, SK, DGH) and Department of Obstetrics and Gynaecology (MSA, DGH), University of British Columbia, Vancouver, Canada; Department of Molecular Oncology, British Columbia Cancer Agency Cancer Research Centre, Vancouver, Canada (YKW, AB, RM, DSG, SPS); Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany (MM, FAT, DW, SB, SK); Division of Anatomic Pathology, Synlab MVZ, Institute of Pathology, Mannheim, Germany (FK); Division of Gynecologic Pathology, Institute of Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (AS); Department of Anatomical Pathology, Vancouver General Hospital, Vancouver, Canada (CBG).
authors.forename: Michael S
authors.initials: MS
authors.lastname: Anglesio
authors.affiliation: Department of Pathology and Laboratory Medicine, (MSA, HMH, JS, HLC, ANK, BSS, MKM, CBG, SK, DGH) and Department of Obstetrics and Gynaecology (MSA, DGH), University of British Columbia, Vancouver, Canada; Department of Molecular Oncology, British Columbia Cancer Agency Cancer Research Centre, Vancouver, Canada (YKW, AB, RM, DSG, SPS); Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany (MM, FAT, DW, SB, SK); Division of Anatomic Pathology, Synlab MVZ, Institute of Pathology, Mannheim, Germany (FK); Division of Gynecologic Pathology, Institute of Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (AS); Department of Anatomical Pathology, Vancouver General Hospital, Vancouver, Canada (CBG).
authors.forename: Yi Kan
authors.initials: YK
authors.lastname: Wang
authors.affiliation: Department of Pathology and Laboratory Medicine, (MSA, HMH, JS, HLC, ANK, BSS, MKM, CBG, SK, DGH) and Department of Obstetrics and Gynaecology (MSA, DGH), University of British Columbia, Vancouver, Canada; Department of Molecular Oncology, British Columbia Cancer Agency Cancer Research Centre, Vancouver, Canada (YKW, AB, RM, DSG, SPS); Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany (MM, FAT, DW, SB, SK); Division of Anatomic Pathology, Synlab MVZ, Institute of Pathology, Mannheim, Germany (FK); Division of Gynecologic Pathology, Institute of Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (AS); Department of Anatomical Pathology, Vancouver General Hospital, Vancouver, Canada (CBG).
authors.forename: Madlen
authors.initials: M
authors.lastname: Maassen
authors.affiliation: Department of Pathology and Laboratory Medicine, (MSA, HMH, JS, HLC, ANK, BSS, MKM, CBG, SK, DGH) and Department of Obstetrics and Gynaecology (MSA, DGH), University of British Columbia, Vancouver, Canada; Department of Molecular Oncology, British Columbia Cancer Agency Cancer Research Centre, Vancouver, Canada (YKW, AB, RM, DSG, SPS); Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany (MM, FAT, DW, SB, SK); Division of Anatomic Pathology, Synlab MVZ, Institute of Pathology, Mannheim, Germany (FK); Division of Gynecologic Pathology, Institute of Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (AS); Department of Anatomical Pathology, Vancouver General Hospital, Vancouver, Canada (CBG).
authors.forename: Hugo M
authors.initials: HM
authors.lastname: Horlings
authors.affiliation: Department of Pathology and Laboratory Medicine, (MSA, HMH, JS, HLC, ANK, BSS, MKM, CBG, SK, DGH) and Department of Obstetrics and Gynaecology (MSA, DGH), University of British Columbia, Vancouver, Canada; Department of Molecular Oncology, British Columbia Cancer Agency Cancer Research Centre, Vancouver, Canada (YKW, AB, RM, DSG, SPS); Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany (MM, FAT, DW, SB, SK); Division of Anatomic Pathology, Synlab MVZ, Institute of Pathology, Mannheim, Germany (FK); Division of Gynecologic Pathology, Institute of Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (AS); Department of Anatomical Pathology, Vancouver General Hospital, Vancouver, Canada (CBG).
authors.forename: Ali
authors.initials: A
authors.lastname: Bashashati
authors.affiliation: Department of Pathology and Laboratory Medicine, (MSA, HMH, JS, HLC, ANK, BSS, MKM, CBG, SK, DGH) and Department of Obstetrics and Gynaecology (MSA, DGH), University of British Columbia, Vancouver, Canada; Department of Molecular Oncology, British Columbia Cancer Agency Cancer Research Centre, Vancouver, Canada (YKW, AB, RM, DSG, SPS); Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany (MM, FAT, DW, SB, SK); Division of Anatomic Pathology, Synlab MVZ, Institute of Pathology, Mannheim, Germany (FK); Division of Gynecologic Pathology, Institute of Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (AS); Department of Anatomical Pathology, Vancouver General Hospital, Vancouver, Canada (CBG).
authors.forename: Janine
authors.initials: J
authors.lastname: Senz
authors.affiliation: Department of Pathology and Laboratory Medicine, (MSA, HMH, JS, HLC, ANK, BSS, MKM, CBG, SK, DGH) and Department of Obstetrics and Gynaecology (MSA, DGH), University of British Columbia, Vancouver, Canada; Department of Molecular Oncology, British Columbia Cancer Agency Cancer Research Centre, Vancouver, Canada (YKW, AB, RM, DSG, SPS); Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany (MM, FAT, DW, SB, SK); Division of Anatomic Pathology, Synlab MVZ, Institute of Pathology, Mannheim, Germany (FK); Division of Gynecologic Pathology, Institute of Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (AS); Department of Anatomical Pathology, Vancouver General Hospital, Vancouver, Canada (CBG).
authors.forename: Robertson
authors.initials: R
authors.lastname: Mackenzie
authors.affiliation: Department of Pathology and Laboratory Medicine, (MSA, HMH, JS, HLC, ANK, BSS, MKM, CBG, SK, DGH) and Department of Obstetrics and Gynaecology (MSA, DGH), University of British Columbia, Vancouver, Canada; Department of Molecular Oncology, British Columbia Cancer Agency Cancer Research Centre, Vancouver, Canada (YKW, AB, RM, DSG, SPS); Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany (MM, FAT, DW, SB, SK); Division of Anatomic Pathology, Synlab MVZ, Institute of Pathology, Mannheim, Germany (FK); Division of Gynecologic Pathology, Institute of Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (AS); Department of Anatomical Pathology, Vancouver General Hospital, Vancouver, Canada (CBG).
authors.forename: Diljot S
authors.initials: DS
authors.lastname: Grewal
authors.affiliation: Department of Pathology and Laboratory Medicine, (MSA, HMH, JS, HLC, ANK, BSS, MKM, CBG, SK, DGH) and Department of Obstetrics and Gynaecology (MSA, DGH), University of British Columbia, Vancouver, Canada; Department of Molecular Oncology, British Columbia Cancer Agency Cancer Research Centre, Vancouver, Canada (YKW, AB, RM, DSG, SPS); Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany (MM, FAT, DW, SB, SK); Division of Anatomic Pathology, Synlab MVZ, Institute of Pathology, Mannheim, Germany (FK); Division of Gynecologic Pathology, Institute of Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (AS); Department of Anatomical Pathology, Vancouver General Hospital, Vancouver, Canada (CBG).
authors.forename: Hector
authors.initials: H
authors.lastname: Li-Chang
authors.affiliation: Department of Pathology and Laboratory Medicine, (MSA, HMH, JS, HLC, ANK, BSS, MKM, CBG, SK, DGH) and Department of Obstetrics and Gynaecology (MSA, DGH), University of British Columbia, Vancouver, Canada; Department of Molecular Oncology, British Columbia Cancer Agency Cancer Research Centre, Vancouver, Canada (YKW, AB, RM, DSG, SPS); Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany (MM, FAT, DW, SB, SK); Division of Anatomic Pathology, Synlab MVZ, Institute of Pathology, Mannheim, Germany (FK); Division of Gynecologic Pathology, Institute of Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (AS); Department of Anatomical Pathology, Vancouver General Hospital, Vancouver, Canada (CBG).
authors.forename: Anthony N
authors.initials: AN
authors.lastname: Karnezis
authors.affiliation: Department of Pathology and Laboratory Medicine, (MSA, HMH, JS, HLC, ANK, BSS, MKM, CBG, SK, DGH) and Department of Obstetrics and Gynaecology (MSA, DGH), University of British Columbia, Vancouver, Canada; Department of Molecular Oncology, British Columbia Cancer Agency Cancer Research Centre, Vancouver, Canada (YKW, AB, RM, DSG, SPS); Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany (MM, FAT, DW, SB, SK); Division of Anatomic Pathology, Synlab MVZ, Institute of Pathology, Mannheim, Germany (FK); Division of Gynecologic Pathology, Institute of Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (AS); Department of Anatomical Pathology, Vancouver General Hospital, Vancouver, Canada (CBG).
authors.forename: Brandon S
authors.initials: BS
authors.lastname: Sheffield
authors.affiliation: Department of Pathology and Laboratory Medicine, (MSA, HMH, JS, HLC, ANK, BSS, MKM, CBG, SK, DGH) and Department of Obstetrics and Gynaecology (MSA, DGH), University of British Columbia, Vancouver, Canada; Department of Molecular Oncology, British Columbia Cancer Agency Cancer Research Centre, Vancouver, Canada (YKW, AB, RM, DSG, SPS); Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany (MM, FAT, DW, SB, SK); Division of Anatomic Pathology, Synlab MVZ, Institute of Pathology, Mannheim, Germany (FK); Division of Gynecologic Pathology, Institute of Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (AS); Department of Anatomical Pathology, Vancouver General Hospital, Vancouver, Canada (CBG).
authors.forename: Melissa K
authors.initials: MK
authors.lastname: McConechy
authors.affiliation: Department of Pathology and Laboratory Medicine, (MSA, HMH, JS, HLC, ANK, BSS, MKM, CBG, SK, DGH) and Department of Obstetrics and Gynaecology (MSA, DGH), University of British Columbia, Vancouver, Canada; Department of Molecular Oncology, British Columbia Cancer Agency Cancer Research Centre, Vancouver, Canada (YKW, AB, RM, DSG, SPS); Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany (MM, FAT, DW, SB, SK); Division of Anatomic Pathology, Synlab MVZ, Institute of Pathology, Mannheim, Germany (FK); Division of Gynecologic Pathology, Institute of Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (AS); Department of Anatomical Pathology, Vancouver General Hospital, Vancouver, Canada (CBG).
authors.forename: Friedrich
authors.initials: F
authors.lastname: Kommoss
authors.affiliation: Department of Pathology and Laboratory Medicine, (MSA, HMH, JS, HLC, ANK, BSS, MKM, CBG, SK, DGH) and Department of Obstetrics and Gynaecology (MSA, DGH), University of British Columbia, Vancouver, Canada; Department of Molecular Oncology, British Columbia Cancer Agency Cancer Research Centre, Vancouver, Canada (YKW, AB, RM, DSG, SPS); Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany (MM, FAT, DW, SB, SK); Division of Anatomic Pathology, Synlab MVZ, Institute of Pathology, Mannheim, Germany (FK); Division of Gynecologic Pathology, Institute of Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (AS); Department of Anatomical Pathology, Vancouver General Hospital, Vancouver, Canada (CBG).
authors.forename: Florin A
authors.initials: FA
authors.lastname: Taran
authors.affiliation: Department of Pathology and Laboratory Medicine, (MSA, HMH, JS, HLC, ANK, BSS, MKM, CBG, SK, DGH) and Department of Obstetrics and Gynaecology (MSA, DGH), University of British Columbia, Vancouver, Canada; Department of Molecular Oncology, British Columbia Cancer Agency Cancer Research Centre, Vancouver, Canada (YKW, AB, RM, DSG, SPS); Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany (MM, FAT, DW, SB, SK); Division of Anatomic Pathology, Synlab MVZ, Institute of Pathology, Mannheim, Germany (FK); Division of Gynecologic Pathology, Institute of Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (AS); Department of Anatomical Pathology, Vancouver General Hospital, Vancouver, Canada (CBG).
authors.forename: Annette
authors.initials: A
authors.lastname: Staebler
authors.affiliation: Department of Pathology and Laboratory Medicine, (MSA, HMH, JS, HLC, ANK, BSS, MKM, CBG, SK, DGH) and Department of Obstetrics and Gynaecology (MSA, DGH), University of British Columbia, Vancouver, Canada; Department of Molecular Oncology, British Columbia Cancer Agency Cancer Research Centre, Vancouver, Canada (YKW, AB, RM, DSG, SPS); Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany (MM, FAT, DW, SB, SK); Division of Anatomic Pathology, Synlab MVZ, Institute of Pathology, Mannheim, Germany (FK); Division of Gynecologic Pathology, Institute of Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (AS); Department of Anatomical Pathology, Vancouver General Hospital, Vancouver, Canada (CBG).
authors.forename: Sohrab P
authors.initials: SP
authors.lastname: Shah
authors.affiliation: Department of Pathology and Laboratory Medicine, (MSA, HMH, JS, HLC, ANK, BSS, MKM, CBG, SK, DGH) and Department of Obstetrics and Gynaecology (MSA, DGH), University of British Columbia, Vancouver, Canada; Department of Molecular Oncology, British Columbia Cancer Agency Cancer Research Centre, Vancouver, Canada (YKW, AB, RM, DSG, SPS); Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany (MM, FAT, DW, SB, SK); Division of Anatomic Pathology, Synlab MVZ, Institute of Pathology, Mannheim, Germany (FK); Division of Gynecologic Pathology, Institute of Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (AS); Department of Anatomical Pathology, Vancouver General Hospital, Vancouver, Canada (CBG).
authors.forename: Diethelm
authors.initials: D
authors.lastname: Wallwiener
authors.affiliation: Department of Pathology and Laboratory Medicine, (MSA, HMH, JS, HLC, ANK, BSS, MKM, CBG, SK, DGH) and Department of Obstetrics and Gynaecology (MSA, DGH), University of British Columbia, Vancouver, Canada; Department of Molecular Oncology, British Columbia Cancer Agency Cancer Research Centre, Vancouver, Canada (YKW, AB, RM, DSG, SPS); Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany (MM, FAT, DW, SB, SK); Division of Anatomic Pathology, Synlab MVZ, Institute of Pathology, Mannheim, Germany (FK); Division of Gynecologic Pathology, Institute of Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (AS); Department of Anatomical Pathology, Vancouver General Hospital, Vancouver, Canada (CBG).
authors.forename: Sara
authors.initials: S
authors.lastname: Brucker
authors.affiliation: Department of Pathology and Laboratory Medicine, (MSA, HMH, JS, HLC, ANK, BSS, MKM, CBG, SK, DGH) and Department of Obstetrics and Gynaecology (MSA, DGH), University of British Columbia, Vancouver, Canada; Department of Molecular Oncology, British Columbia Cancer Agency Cancer Research Centre, Vancouver, Canada (YKW, AB, RM, DSG, SPS); Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany (MM, FAT, DW, SB, SK); Division of Anatomic Pathology, Synlab MVZ, Institute of Pathology, Mannheim, Germany (FK); Division of Gynecologic Pathology, Institute of Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (AS); Department of Anatomical Pathology, Vancouver General Hospital, Vancouver, Canada (CBG).
authors.forename: C Blake
authors.initials: CB
authors.lastname: Gilks
authors.affiliation: Department of Pathology and Laboratory Medicine, (MSA, HMH, JS, HLC, ANK, BSS, MKM, CBG, SK, DGH) and Department of Obstetrics and Gynaecology (MSA, DGH), University of British Columbia, Vancouver, Canada; Department of Molecular Oncology, British Columbia Cancer Agency Cancer Research Centre, Vancouver, Canada (YKW, AB, RM, DSG, SPS); Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany (MM, FAT, DW, SB, SK); Division of Anatomic Pathology, Synlab MVZ, Institute of Pathology, Mannheim, Germany (FK); Division of Gynecologic Pathology, Institute of Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (AS); Department of Anatomical Pathology, Vancouver General Hospital, Vancouver, Canada (CBG).
authors.forename: Stefan
authors.initials: S
authors.lastname: Kommoss
authors.affiliation: Department of Pathology and Laboratory Medicine, (MSA, HMH, JS, HLC, ANK, BSS, MKM, CBG, SK, DGH) and Department of Obstetrics and Gynaecology (MSA, DGH), University of British Columbia, Vancouver, Canada; Department of Molecular Oncology, British Columbia Cancer Agency Cancer Research Centre, Vancouver, Canada (YKW, AB, RM, DSG, SPS); Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany (MM, FAT, DW, SB, SK); Division of Anatomic Pathology, Synlab MVZ, Institute of Pathology, Mannheim, Germany (FK); Division of Gynecologic Pathology, Institute of Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (AS); Department of Anatomical Pathology, Vancouver General Hospital, Vancouver, Canada (CBG). dhuntma@bccancer.bc.ca.
authors.forename: David G
authors.initials: DG
authors.lastname: Huntsman
mesh_terms: D000328:Adult; D000368:Aged; D018269:Carcinoma, Endometrioid / Q000235:genetics* / Q000473:pathology; D000077216:Carcinoma, Ovarian Epithelial; D002999:Clone Cells; D004273:DNA, Neoplasm / Q000032:analysis*; D016889:Endometrial Neoplasms / Q000235:genetics* / Q000473:pathology; D059472:Exome; D005260:Female; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000235:genetics* / Q000473:pathology; D009378:Neoplasms, Multiple Primary / Q000235:genetics* / Q000473:pathology; D010051:Ovarian Neoplasms / Q000235:genetics* / Q000473:pathology; D018401:Sample Size; D017422:Sequence Analysis, DNA / Q000379:methods
chemical_list: D004273:DNA, Neoplasm