High prevalence of atypical hyperplasia in the endometrium of patients with epithelial ovarian cancer

Am J Clin Pathol. 2014 Aug;142(2):213-21. doi: 10.1309/AJCPTGJOPXUW6RVO.


Objectives: The aim of the present study is to determine the prevalence of endometrial premalignancies in women diagnosed with epithelial ovarian cancer (EOC).

Methods: Endometrial and ovarian specimens of 186 patients with EOC were retrospectively selected using the nationwide pathology network and registry, and sections were comprehensively reviewed: 136 (73%) serous, 19 (10%) endometrioid, 15 (8%) mucinous, seven (4%) clear cell, and nine (5%) undifferentiated. Immunohistochemical phenotypes were compared for patients with serous EOC with concurrent endometrial pathology.

Results: In 31%, endometrial (pre)malignancy was found: carcinoma in 3%, endometrial intraepithelial carcinoma (EIC) in 4%, and atypical hyperplasia in 24%. Atypical hyperplasia was found in 47% of endometrioid EOCs but in 7% to 33% of other subtypes. Body mass index was higher concurrent to atypical hyperplasia (P=.001). Serous EOC and EIC immunophenotypes were comparable, whereas atypical hyperplasia was expressed differently.

Conclusions: Apart from synchronous endometrial carcinoma, endometrial premalignancies should be taken into account when determining optimal treatment for women diagnosed with EOC.

Keywords: Atypical hyperplasia; Endometrial intraepithelial carcinoma; Endometrium; Epithelial ovarian cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Ovarian Epithelial
  • Endometrium / metabolism*
  • Female
  • Humans
  • Hyperplasia / epidemiology*
  • Hyperplasia / pathology
  • Middle Aged
  • Neoplasms, Glandular and Epithelial / epidemiology*
  • Neoplasms, Glandular and Epithelial / therapy
  • Ovarian Neoplasms / epidemiology*
  • Ovarian Neoplasms / therapy
  • Precancerous Conditions / pathology
  • Prevalence
  • Retrospective Studies