Akademik Veri Yönetim Sistemi
UTAK (ITAC) 2025 ‘’TÜM YÖNLERİ İLE ADLİ TIP VE PATOLOJİ’’ (MULTIDIMENSIONAL FORENSIC MEDICINE & PATHOLOGY), Samarqand, Özbekistan, 11 - 13 Eylül 2025, ss.283-284, (Tam Metin Bildiri)
Endometriosis is a benign but chronic disease characterized by the ectopic presence of endometrial glands and stroma. In some cases, it may undergo malignant transformation due to chronic inflammation and hormonal influences. Atypical endometriosis (AE), defined by cytologic and architectural atypia, is considered a potential precursor lesion, though its molecular and histopathological characteristics remain unclear. This study aimed to investigate the role of AE in malignant transformation. This retrospective study included patients diagnosed with endometriosis and malignancies arising in the background of AE between 2011 and 2025 at our institution. A total of 4,546 endometriosis cases were reviewed. Clinical history, morphological features, and immunohistochemical findings were evaluated. The relationship between AE and malignant transformation, as well as the distribution of tumor types, was analyzed. The patients' ages ranged from 19 to 81 years. AE was diagnosed in 0.9% (40/4,546) of cases. Malignant tumors arising in the context of endometriosis were identified in 292 cases—25% in the endometrium and 75% in the ovaries or fallopian tubes. Among AE cases, 32.5% (13/40) developed malignancy, with a mean age of 41 years. In comparison, the malignant transformation rate in non-AE endometriosis was 6.2% (279/4,506), with a mean age of 49.6 years. The histological distribution of malignant cases was as follows: 50.3% endometrioid carcinoma, 21.2% clear cell carcinoma, 14.4% serous carcinoma, 4.1% borderline tumors, 3.1% mixed carcinoma (endometrioid/clear cell), 2.7% mucinous carcinoma, and 4.1% other rare tumor types. This study shows a higher-than-expected rate of malignant transformation in endometriosis, particularly in cases with AE. The high transformation rate (32.5%) and younger age of AE patients support the consideration of AE as a precancerous lesion. Early identification of AE may warrant closer clinical monitoring to prevent malignant progression.