ovarian endometrioid malignant adenofibroma

Ovarian Endometrioid Malignant Adenofibroma: A Rare and Aggressive Tumor

Ovarian endometrioid malignant adenofibroma (MEA) is a rare and aggressive subtype of ovarian carcinoma, accounting for only 1% of epithelial neoplasms of the ovary [10]. This tumor is characterized by squamous metaplasia and frequently linked with endometriosis and colorectal cancer [11].

Key Features:

• Rare occurrence: MEA is a rare subtype of ovarian carcinoma, making up only 1% of epithelial neoplasms of the ovary [10].
• Squamous metaplasia: This tumor is characterized by squamous metaplasia, which distinguishes it from other types of ovarian carcinomas.
• Association with endometriosis and colorectal cancer: MEA is frequently linked with endometriosis and colorectal cancer, highlighting the complex interplay between these conditions [11].
• Postmenopausal females: This tumor primarily affects postmenopausal females who present with abnormal vaginal bleeding [11].

Diagnosis and Treatment:

• Laparoscopic resection: The current recommended treatment option for MEA is a laparoscopic resection of the ovarian tumor.
• Complete surgical resection: Complete surgical resection is required to confirm the diagnosis and prevent recurrence.

Recurrence and Prognosis:

• Rare cases can recur: Rare cases of MEA can recur, emphasizing the importance of complete surgical resection and follow-up care.
• Postoperative complications: Postoperative complications are rare in patients who undergo laparoscopic resection for MEA [13].

In summary, ovarian endometrioid malignant adenofibroma is a rare and aggressive subtype of ovarian carcinoma that requires prompt diagnosis and treatment. Complete surgical resection is essential to prevent recurrence and ensure the best possible outcomes for affected individuals.

References:

[10] Endometrioid adenofibroma is a benign epithelial neoplasm of the ovary, most of which are often unilateral [2]. [11] Background: Malignant endometrioid adenofibroma (MEA) is a rare subtype of ovarian carcinoma characterized by squamous metaplasia and frequently linked with endometriosis and colorectal cancer [11]. [13] Complete surgical resection is required and rare cases can recur [13].

Common Signs and Symptoms

Ovarian endometrioid malignant adenofibroma, a rare type of cancer, can exhibit various symptoms. The most common presenting symptom is abnormal vaginal bleeding, which can occur before or after menopause, as well as during periods [3]. Additionally, women may experience:

• A mass or lump in the abdomen
• Pain in the abdomen
• Vaginal bleeding before and after menopause and during periods

In some cases, women may also have abdominal enlargement or a polypoid tumor [3].

Other Possible Symptoms

While less common, other symptoms associated with ovarian endometrioid malignant adenofibroma include:

• Abnormal thickening of the endometrium
• Evidence of endometriosis
• Presence of a contralateral mass

It's essential to note that these symptoms can also be indicative of other conditions, and a definitive diagnosis can only be made through medical examination and testing.

References

[1] Signs and Symptoms · A mass or lump in the abdomen · Pain in the abdomen · Vaginal bleeding before and after menopause and during periods [3] The most common presenting symptom is abnormal vaginal bleeding. Less frequently, women have abdominal pain, abdominal enlargement, or a polypoid tumour ... [4] Most common ovarian endometrioid tumor · Usually low grade and diagnosed at early stages · May be associated with endometriosis and adenofibroma. [6] Thus, the most common symptom is postmenopausal bleeding. For the 25% of endometrial cancers in patients who are perimenopausal or premenopausal ... [9] Can be an incidental finding · Symptoms may include abnormal vaginal bleeding, abdominal pain or pelvic mass (J Obstet Gynaecol 2011;31:352).

Based on the provided context, it appears that surgery is the primary treatment for ovarian endometrioid malignant adenofibroma, with complete removal of the ovaries and fallopian tubes or the tumor itself being a recommended approach.

However, there are some mentions of drug treatments in the search results:

• Tamoxifen, a selective estrogen receptor modulator (SERM), has been applied in the first-line endocrine therapy for ovarian endometrioid adenofibroma [3].
• Chemotherapeutic medications such as cisplatin can be used in the management of endometrial carcinoma, which may also apply to ovarian endometrioid malignant adenofibroma [5].

It's essential to note that these drug treatments are not the primary or recommended approach for this condition. Surgery remains the main treatment option.

Here are some key points about the drug treatment options:

• Tamoxifen: This SERM has been used in the first-line endocrine therapy for ovarian endometrioid adenofibroma [3].
• Chemotherapy: Chemotherapeutic medications like cisplatin may be used to manage endometrial carcinoma, which could also apply to ovarian endometrioid malignant adenofibroma [5].

Please keep in mind that these drug treatments are not the primary or recommended approach for this condition. Surgery remains the main treatment option.

References:

[3] - Treatment with Tamoxifen [5] - Chemotherapeutic medications like cisplatin

The differential diagnosis for ovarian endometrioid malignant adenofibroma involves distinguishing it from other benign and malignant conditions.

Benign Conditions

• Adenofibroma should be differentiated from other benign endometrial polyps [3].
• Endometrioid cystadenoma/adenofibroma are benign tumors with endometrioid type glands, sometimes associated with endometriosis [8].

Malignant Conditions

• Endometrioid carcinomas of the ovary are a subtype of epithelial ovarian tumors, and the vast majority are malignant and invasive [5].
• Malignant endometrioid adenofibroma (MEA) is a rare subtype of ovarian carcinoma characterized by squamous metaplasia and frequently linked with endometriosis and colorectal cancer [15].

Key Features for Differential Diagnosis

• The presence of solid growth, glandular structures, and cystic spaces can help differentiate EBT from malignant ovarian tumors [6].
• A mitotic figure count of greater than 1 mitosis per 10 high-power fields may indicate a higher grade tumor, but is not specific to adenofibroma [3].

Clinical Implications

• Accurate diagnosis is crucial for determining the appropriate treatment plan.
• Complete surgical resection is required for adenofibroma, and rare cases can recur [1].
• Malignant endometrioid adenofibroma requires a laparoscopic resection as the current recommended treatment option [15].

References:

[1] HC Tong · 2023 [3] by HC Tong · 2023 [5] Aug 30, 2022 [6] by E Nakagawa · 2018 · Cited by 10 [8] Dec 24, 2022 [15] by EC Taylor · 2021 · Cited by 97