Abstract
The vast majority of precancerous lesions of the gynecologic tract are diagnosed post hoc. Often the surgery by which the lesion was diagnosed is sufficient treatment. However, a few exceptions exist. The most notable is endometrial hyperplasia, which is usually diagnosed on an endometrial biopsy or curettage and definitively treated with hysterectomy. Nonsurgical treatment of endometrial hyperplasia can be considered in select patients. The role of surgical staging (lymphadenectomy, omentectomy, etc.) for the majority of precancerous lesions of the fallopian tube and ovary is unclear. In the absence of upstaged and confirmed invasive carcinoma, adjuvant chemotherapy is not recommended.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Marra C, Penati C, Ferrari L, Cantu MG, Bargossi L, Fruscio R. Treatment of simple and complex endometrial non-atypical hyperplasia with natural progesterone: response rate to different doses. Gynecol Endocrinol. 2014;30(12):1–3.
Niwa K, Tagami K, Lian Z, Onogi K, Mori H, Tamaya T. Outcome of fertility-preserving treatment in young women with endometrial carcinomas. BJOG. 2005;112:317–20.
Yu M, Yang JX, Wu M, Lang JH, Huo Z, Shen K. Fertility-preserving treatment in young women with well-differentiated endometrial carcinoma and severe atypical hyperplasia of endometrium. Fertil Steril. 2009;92:2122–4.
Trimble CL, Kauderer J, Zaino R, Silverberg S, Lim PC, Burke II JJ, Alberts D, Curtin J. Concurrent endometrial carcinoma in women with a biopsy diagnosis of atypical endometrial hyperplasia: a Gynecologic Oncology Group study. Cancer. 2006;106:812–9.
Walsh C, Holschneider C, Hoang Y, Tieu K, Karlan B, Cass I. Coexisting ovarian malignancy in young women with endometrial cancer. Obstet Gynecol. 2005;106:693–9.
Evans-Metcalf ER, Brooks SE, Reale FR, Baker SP. Profile of women 45 years of age and younger with endometrial cancer. Obstet Gynecol. 1998;91:349–54.
Lee TS, Kim JW, Kim TJ, Cho CH, Ryu SY, Ryu HS, Kim BG, Lee KH, Kim YM, Kang SB, Korean Gynecologic Oncology G. Ovarian preservation during the surgical treatment of early stage endometrial cancer: a nation-wide study conducted by the Korean Gynecologic Oncology Group. Gynecol Oncol. 2009;115:26–31.
Richter CE, Qian B, Martel M, Yu H, Azodi M, Rutherford TJ, Schwartz PE. Ovarian preservation and staging in reproductive-age endometrial cancer patients. Gynecol Oncol. 2009;114:99–104.
Zheng W, Schwartz PE. Serous EIC as an early form of uterine papillary serous carcinoma: recent progress in understanding its pathogenesis and current opinions regarding pathologic and clinical management. Gynecol Oncol. 2005;96:579–82.
Hou JY, McAndrew TC, Goldberg GL, Whitney K, Shahabi S. A clinical and pathologic comparison between stage-matched endometrial intraepithelial carcinoma and uterine serous carcinoma: is there a difference? Reprod Sci. 2014;21:532–7.
Sherman ME, Bitterman P, Rosenshein NB, Delgado G, Kurman RJ. Uterine serous carcinoma. A morphologically diverse neoplasm with unifying clinicopathologic features. Am J Surg Pathol. 1992;16:600–10.
Soslow RA, Pirog E, Isacson C. Endometrial intraepithelial carcinoma with associated peritoneal carcinomatosis. Am J Surg Pathol. 2000;24:726–32.
Baergen RN, Warren CD, Isacson C, Ellenson LH. Early uterine serous carcinoma: clonal origin of extrauterine disease. Int J Gynecol Pathol. 2001;20:214–9.
Zheng W, Xiang L, Fadare O, Kong B. A proposed model for endometrial serous carcinogenesis. Am J Surg Pathol. 2011;35:e1–14.
Jia L, Liu Y, Yi X, Miron A, Crum CP, Kong B, Zheng W. Endometrial glandular dysplasia with frequent p53 gene mutation: a genetic evidence supporting its precancer nature for endometrial serous carcinoma. Clin Cancer Res. 2008;14:2263–9.
Zheng W, Liang SX, Yu H, Rutherford T, Chambers SK, Schwartz PE. Endometrial glandular dysplasia: a newly defined precursor lesion of uterine papillary serous carcinoma. Part I: morphologic features. Int J Surg Pathol. 2004;12:207–23.
Lim S, Kim HS, Lee KB, Yoo CW, Park SY, Seo SS. Does the use of a uterine manipulator with an intrauterine balloon in total laparoscopic hysterectomy facilitate tumor cell spillage into the peritoneal cavity in patients with endometrial cancer? Int J Gynecol Cancer. 2008;18:1145–9.
Sonoda Y, Zerbe M, Smith A, Lin O, Barakat RR, Hoskins WJ. High incidence of positive peritoneal cytology in low-risk endometrial cancer treated by laparoscopically assisted vaginal hysterectomy. Gynecol Oncol. 2001;80:378–82.
Eltabbakh GH, Mount SL. Laparoscopic surgery does not increase the positive peritoneal cytology among women with endometrial carcinoma. Gynecol Oncol. 2006;100:361–4.
Olivier RI, van Beurden M, Lubsen MA, Rookus MA, Mooij TM, van de Vijver MJ, van’t Veer LJ. Clinical outcome of prophylactic oophorectomy in BRCA1/BRCA2 mutation carriers and events during follow-up. Br J Cancer. 2004;90:1492–7.
Wethington SL, Park KJ, Soslow RA, Kauff ND, Brown CL, Dao F, Otegbeye E, Sonoda Y, Abu-Rustum NR, Barakat RR, Levine DA, Gardner GJ. Clinical outcome of isolated serous tubal intraepithelial carcinomas (STIC). Int J Gynecol Cancer. 2013;23:1603–11.
Powell CB, Swisher EM, Cass I, McLennan J, Norquist B, Garcia RL, Lester J, Karlan BY, Chen L. Long term follow up of BRCA1 and BRCA2 mutation carriers with unsuspected neoplasia identified at risk reducing salpingo-oophorectomy. Gynecol Oncol. 2013;129:364–71.
Gilks CB, Irving J, Kobel M, Lee C, Singh N, Wilkinson N, McCluggage WG. Incidental nonuterine high-grade serous carcinomas arise in the fallopian tube in most cases: further evidence for the tubal origin of high-grade serous carcinomas. Am J Surg Pathol. 2015;39:357–64.
Moll UM, Chumas JC, Chalas E, Mann WJ. Ovarian carcinoma arising in atypical endometriosis. Obstet Gynecol. 1990;75:537–9.
Chalas E, Chumas J, Barbieri R, Mann WJ. Nucleolar organizer regions in endometriosis, atypical endometriosis, and clear cell and endometrioid carcinomas. Gynecol Oncol. 1991;40:260–3.
Tanase Y, Furukawa N, Kobayashi H, Matsumoto T. Malignant transformation from endometriosis to atypical endometriosis and finally to endometrioid adenocarcinoma within 10 years. Case Rep Oncol. 2013;6:480–4.
Fukunaga M, Nomura K, Ishikawa E, Ushigome S. Ovarian atypical endometriosis: its close association with malignant epithelial tumours. Histopathology. 1997;30:249–55.
Bell KA, Kurman RJ. A clinicopathologic analysis of atypical proliferative (borderline) tumors and well-differentiated endometrioid adenocarcinomas of the ovary. Am J Surg Pathol. 2000;24:1465–79.
Uzan C, Berretta R, Rolla M, Gouy S, Fauvet R, Darai E, Duvillard P, Morice P. Management and prognosis of endometrioid borderline tumors of the ovary. Surg Oncol. 2012;21:178–84.
Bell DA, Scully RE. Benign and borderline clear cell adenofibromas of the ovary. Cancer. 1985;56:2922–31.
Snyder RR, Norris HJ, Tavassoli F. Endometrioid proliferative and low malignant potential tumors of the ovary. A clinicopathologic study of 46 cases. Am J Surg Pathol. 1988;12:661–71.
Roth LM, Emerson RE, Ulbright TM. Ovarian endometrioid tumors of low malignant potential: a clinicopathologic study of 30 cases with comparison to well-differentiated endometrioid adenocarcinoma. Am J Surg Pathol. 2003;27:1253–9.
Uzan C, Dufeu-Lefebvre M, Fauvet R, Gouy S, Duvillard P, Darai E, Morice P. Management and prognosis of clear cell borderline ovarian tumor. Int J Gynecol Cancer. 2012;22:993–9.
Zhao C, Wu LS, Barner R. Pathogenesis of ovarian clear cell adenofibroma, atypical proliferative (borderline) tumor, and carcinoma: clinicopathologic features of tumors with endometriosis or adenofibromatous components support two related pathways of tumor development. J Cancer. 2011;2:94–106.
Vasilakaki T, Skafida E, Arkoumani E, Grammatoglou X, Firfiris N, Manoloudaki K. Borderline clear cell adenofibroma of the ovary associated with ovarian endometriosis: a case report. Eur J Gynaecol Oncol. 2012;33:230–2.
Katsube Y, Fujiwara H, Tanioka Y, Imajo M, Fujiwara A. Ovarian clear cell adenofibroma of borderline malignancy. A case report. Hiroshima J Med Sci. 1989;38:87–90.
Suzuki A, Shiozawa T, Mori A, Kimura K, Konishi I. Cystic clear cell tumor of borderline malignancy of the ovary lacking fibromatous components: report of two cases and a possible new histological subtype. Gynecol Oncol. 2006;101:540–4.
Narese F, Virzi G, Narese D, Orlando AA, Vinti D, Virzi V. MR imaging of a bilateral ovarian clear cell borderline adenofibromatous tumor. Clin Ter. 2014;165:249–51.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Stickles, X.B. (2016). Clinical Management of Selected Precancerous Lesions of the Uterus, Fallopian Tube, and Ovary. In: Fadare, O. (eds) Precancerous Lesions of the Gynecologic Tract. Springer, Cham. https://doi.org/10.1007/978-3-319-22509-8_4
Download citation
DOI: https://doi.org/10.1007/978-3-319-22509-8_4
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-22508-1
Online ISBN: 978-3-319-22509-8
eBook Packages: MedicineMedicine (R0)