Abstract
Malignant transformation of endometriosis is a well-documented process with over 300 cases presented in the literature. The majority of these cases arise in ovarian endometriosis; however, approximately 25% are found in extragonadal sites. Although not definitely proven, a theory has been proposed in several reports that the use of unopposed estrogen in women with a history of endometriosis who have undergone hysterectomy may be a contributing factor. Several of these studies have therefore suggested the addition of a progestational agent for these women. Endometriotic implants share not only a common histology with the endometrium, but also similar function and responsiveness to the hormonal milieu. As in the case of women with a uterus, and consequently an endometrium, the use of unopposed estrogen may present a risk factor for malignant transformation of endometriosis. Diagnosis and treatment of these malignancies is based on tumor location and histology, similar to analogous malignancies of the uterus and ovaries.
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