title: Association of ovarian hyperthecosis with endometrial polyp, endometrial hyperplasia, and endometrioid adenocarcinoma in postmenopausal women: a clinicopathological study of 238 cases.
abstract: Ovarian hyperthecosis, a source of estrogen, may occur in postmenopausal women. In this study, we evaluated the possible association of ovarian hyperthecosis with endometrial polyp, endometrial hyperplasia, and endometrioid adenocarcinoma in postmenopausal women. Our study consisted of 238 postmenopausal women: 108 with endometrioid adenocarcinoma and 130 without endometrial carcinoma. The International Federation of Gynecology and Obstetrics system was used to grade endometrioid adenocarcinoma. Within the endometrioid adenocarcinoma cases, 48 (44.4%) were grade 1, 46 (42.6%) were grade 2, and 14 (13.0%) were grade 3. Among the noncancer cases, 71 (54.6%) had atrophic endometrium, 32 (24.6%) had endometrial polyp, and 27 (20.8%) had endometrial hyperplasia. The frequency of ovarian hyperthecosis in patients with endometrial polyp (46.9%), endometrial hyperplasia (55.6%), and grade 1 (43.8%), grade 2 (54.3%), and grade 3 (57.1%) endometrioid adenocarcinoma was each significantly higher than that in patients with atrophic endometrium (23.9%), supporting an association of these lesions with ovarian hyperthecosis in postmenopausal women. There was no statistically significant difference in the rate of ovarian hyperthecosis among patients with endometrial polyp, endometrial hyperplasia, and grade 1, grade 2, and grade 3 endometrioid adenocarcinoma. Our study indicates that ovarian hyperthecosis with its resultant risk factor of hyperestrinism may contribute to the pathogenesis of endometrial polyp, endometrial hyperplasia, and endometrioid adenocarcinoma in postmenopausal women. Although some studies show that grade 3 endometrioid adenocarcinoma has different genetic/molecular changes from its lower-grade counterparts, our study suggests that endometrioid adenocarcinoma of all grades may share the common risk factor of hyperestrinism.
authors.affiliation: Department of Pathology, Kent Hospital, Warwick, RI 02886; Department of Pathology, Women & Infants Hospital of Rhode Island, Providence, RI 02905; Department of Pathology, Warren Alpert Medical School, Brown University, Providence, RI 02912. Electronic address: czhang@kentri.org.
authors.forename: Cunxian
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Pathology, Women & Infants Hospital of Rhode Island, Providence, RI 02905; Department of Pathology, Warren Alpert Medical School, Brown University, Providence, RI 02912.
authors.forename: C James
authors.initials: CJ
authors.lastname: Sung
authors.affiliation: Department of Pathology, Women & Infants Hospital of Rhode Island, Providence, RI 02905; Department of Pathology, Warren Alpert Medical School, Brown University, Providence, RI 02912.
authors.forename: M Ruhul
authors.initials: MR
authors.lastname: Quddus
authors.affiliation: Department of Pathology, Women & Infants Hospital of Rhode Island, Providence, RI 02905; Department of Pathology, Warren Alpert Medical School, Brown University, Providence, RI 02912.
authors.forename: Rochelle A
authors.initials: RA
authors.lastname: Simon
authors.affiliation: Department of Pathology, Kent Hospital, Warwick, RI 02886; Department of Pathology, Women & Infants Hospital of Rhode Island, Providence, RI 02905; Department of Pathology, Warren Alpert Medical School, Brown University, Providence, RI 02912.
authors.forename: Tarek
authors.initials: T
authors.lastname: Jazaerly
authors.affiliation: Department of Pathology, Women & Infants Hospital of Rhode Island, Providence, RI 02905; Department of Pathology, Warren Alpert Medical School, Brown University, Providence, RI 02912.
authors.forename: W Dwayne
authors.initials: WD
authors.lastname: Lawrence
mesh_terms: D001706:Biopsy; D018269:Carcinoma, Endometrioid / Q000473:pathology* / Q000601:surgery; D016022:Case-Control Studies; D004714:Endometrial Hyperplasia / Q000473:pathology* / Q000601:surgery; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery; D004717:Endometrium / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D060787:Neoplasm Grading; D010053:Ovary / Q000473:pathology*; D011127:Polyps / Q000473:pathology* / Q000601:surgery; D017698:Postmenopause
keywords: Endometrial hyperplasia; Endometrial polyp; Endometrioid adenocarcinoma; Ovarian hyperthecosis; Postmenopausal