Synchronous Endometrial and Ovarian Cancer in Young Women: Case Report and Review of the Literature.
Young women with endometrial cancer (EC) have an increased risk of synchronous ovarian cancer. The prognosis of women with synchronous endometrial and ovarian cancer (SEOC) is good. A high proportion of affected women have hereditary non-polyposis colon cancer syndrome (HNPCC).



We present the case of a 45-year-old woman with histologically proven endometrioid adenocarcinoma of the endometrium (pT1B, G2, R0 without lymphovascular space invasion). She underwent laparoscopic hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy. Final histology revealed a synchronous bilateral endometrioid ovarian cancer (pT1A, G2, R0). HNPCC analysis by immunohistochemistry showed no microsatellite instability in MSH2, MSH6, MLH1, and PMS2. No adjuvant therapy was administered, clinical follow-up with regular gynecological examinations was recommended. In a systematic literature review, 2,904 cases of women with SEOC were identified with 1,035 (36%) of them being premenopausal or <50 years of age. The proportion of women with SEOC among all reported EC cases was 842/23,498 (3%) and the proportion of young women with SEOC among all reported EC cases was 261/23,498 (1%). In summary, microsatellite instability and subsequent mutations in mismatch repair genes compatible with HNPCC were identified in 6/15 (40%) women analyzed. The mean recurrence-free and overall survival times of young women with SEOC were 1.9 (min 0.2, max 3) and 4.0 (min 0.2, max 22.1) years, respectively.



Young women with EC have a high risk of synchronous ovarian cancer. Thus, in young women with EC, bilateral salpingo-oophorectomy or careful histological assessment of both ovaries are recommended in order to confirm or rule out SEOC. HNPCC testing should be offered to all women.
Department of Obstetrics and Gynecology, Ruhr-Universität Bochum, Bochum, Germany.
Askin
A
Dogan
Department of Hematology and Oncology, Ruhr-Universität Bochum, Bochum, Germany.
Beate
B
Schultheis
Department of Obstetrics and Gynecology, Ruhr-Universität Bochum, Bochum, Germany.
Günther A
GA
Rezniczek
Department of Obstetrics and Gynecology, Ruhr-Universität Bochum, Bochum, Germany.
Ziad
Z
Hilal
Department of Obstetrics and Gynecology, Ruhr-Universität Bochum, Bochum, Germany.
Cem
C
Cetin
Karl Landsteiner Institute of Gynecological Diagnostics & Therapy, Mauerbach, Austria.
Günther
G
Häusler
Department of Obstetrics and Gynecology, Ruhr-Universität Bochum, Bochum, Germany clemens.tempfer@rub.de.|Karl Landsteiner Institute of Gynecological Diagnostics & Therapy, Mauerbach, Austria.
Clemens B
CB
Tempfer
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D000328:Adult; D000465:Algorithms; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000150:complications / Q000235:genetics; D004260:DNA Repair; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007150:Immunohistochemistry; D053842:Microsatellite Instability; D018895:Microsatellite Repeats / Q000235:genetics; D008875:Middle Aged; D009154:Mutation; D009364:Neoplasm Recurrence, Local; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology
HNPCC; Ovarian cancer; cancer syndrome; endometrial cancer; review; synchronous cancer; young women