Endometriosis Causes And Endometriosis Cancer

Endometriosis Causes And Endometriosis Cancer


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Endometriosis causes and endometriosis cancer


        It is not known the exact endometriosis causes, but there were many hypotheses and theories discussed. The menstrual blood is containing endometrial cells and they can divide and locate in different organs to form endometrial lesions. This theory is accepted by most gynecologists, but does not explain the etiology of endometriosis with cerebral or pulmonary location. Other theories suggest different mechanisms of occurrence of endometriosis. One says that endometriosis lesions occur secondary to the transport of endometrial tissue in the marrow or lymphatic route.

        Another theory involves the immune system deficiency in the development of endometriosis, as well as genetic factors. One theory is that endometrial fragments reach the fallopian tubes and pelvic cavity where is fixed on reproductive organs. During menstruation, the tissue bleed, as the lining of the uterus. Blood from these regions may cause irritation of tissues, which become inflamed. Over time, cysts and scar tissue can form. No one knows for sure, the endometriosis causes or why some women are affected, but the family history influence the occurrence of this disease. Several theories have been issued in relation to the development of endometriosis.

        Under one of them, the menstrual fluid, which normally would flow from the vagina, it follows a contrary movement and goes back into the uterus (retrograde menstruation). Pieces of the uterine lining bind to other organs and grow. Since the phenomenon of retrograde menstruation is quite common, other researchers hypothesize that one of the endometriosis causes by a deficiency of the immune system. According to another theory, endometrial cells are transported in the blood. Environmental causes, such as exposure to dioxins, are also being investigated.

Endometriosis cancer

       Endometriosis is a disease that remains poorly understood even today. The disease has many similarities with malignant disease: the clinical evolution is characterized by the risk of recurrence and dissemination. One issue that remains unclear is the association between endometriosis and cancer pathology. In fact we know very little about the mechanisms of malignant transformation of endometriosis. On the other hand the endometriosis seems to be frequently associated with some primary tumors.

       To confirm the diagnosis of endometriosis cancer, several criteria must be present.

  • You must remove a primary tumor and the possibility of a metastasis of another tumor.
  • The histologic appearance must be compatible with the origin of endometriosis;
  • There must be a transition zone between endometriosis tissue and malignant tissue.

       Histologically it is most commonly endometrioid adenocarcinoma , sometimes associated with clear carcinoma, very rarely carcinosarcoma or adenocarcinoma.

Incidence of malignant lesions of endometriosis

       This is an exceptional pathology. The malignant lesions of endometriosis would be between 0.26 and 1% . We must differentiate between malignant and spontaneous carcinogenesis promoted by hyperoestrogenism . On a related study in 205 cases, including 191 patients with no history of taking HRT(hormone promoting terapy) the localization was predominantly extra-ovarian (44% including 3.4% in the recto-vaginal wall).

Incidence of in ovarian endometriosis cancer

       We must differentiate degeneration of an outbreak of endometriosis and the association of ovarian cancer and endometriosis. 1.6 to 3.5% of epithelial ovarian tumors are malignant to a benign endometriosis . The pelvic endometriosis is associated in 10-25% with endometrioid carcinoma in the ovary . This association is more common in Japan. The presence of ovarian cancer where there is an endometrioma would be 0.7% . The risk of developing ovarian cancer if there is a history of endometriosis is increased by 30%. There is insufficient data to assess whether the prognosis of ovarian cancer is modified when combined with endometriosis or is secondary to degeneration of endometriosis. A higher incidence of breast cancer and lymphoma was found in women with endometriosis.

Genetic Factors

       Several genetic abnormalities are found in cells of endometriosis. Some of these abnormalities are also found in tumor cells or tumor may explain the degeneration. Aneuploidy of chromosome 17 was found in 65% of severe endometriosis lesions examined. This anomaly appears to play a role in the development and progression of endometriosis cancer.

       Various chromosomal abnormalities are found in women with endometriosis]. Losses at chromosomes 1 and 22 are found in 50% of cases, other chromosomes are also affected but with less frequency, it is chromosome 5, 6 and 17. At the molecular level, the mechanism of invasion of collagen by endometriotic cells share some characteristics with metastatic neoplastic cells. In conclusion, there are many clinical, epidemiological and genetic features, demonstrating a relationship between endometriosis and cancer pathology. A better understanding of this relationship would improve the treatment of endometriosis.