Abstract
BackgroundTo determine the prevalence of and risk factors for malignant transformation of ovarian endometrioma during dienogest therapy, which is very rare, we examined multiple cases of malignant transformation of ovarian endometrioma during dienogest therapy and performed a multivariate analysis of the records in our hospital.MethodsThe medical records of 174 patients who underwent DNGT for the treatment of OMA from June 1, 2011, to May 31, 2018, were reviewed retrospectively with the approval of the Human Ethical Committee of the University of Teikyo Hospital. And we provided one representative case of MT with obtaining written informed consent. To assess the effects of six representative factors, including advanced age, parity, surgical history, and endometrial cyst characteristics (including 3 factors), on the possibility of malignant transformation, we performed a multivariate logistic regression analysis.ResultsOf the 174 cases, 4 were diagnosed with malignant transformation, and these cases are reported. In the multivariate analysis, advanced age (P = 0.0064), nullipara (P = 0.0322), and enlargement (P = 0.0079) showed significant differences for malignant transformation occurrence. All 4 malignant transformation cases were among the 19 patients who had all of these 3 factors.ConclusionsFor a more accurate determination of the treatment approach, a larger sample size will be needed to determine the risk factors for malignant transformation during dienogest therapy.
Highlights
To determine the prevalence of and risk factors for malignant transformation of ovarian endometrioma during dienogest therapy, which is very rare, we examined multiple cases of malignant transformation of ovarian endometrioma during dienogest therapy and performed a multivariate analysis of the records in our hospital
Recent studies have indicated that endometrioid carcinoma and clear cell carcinoma are associated with ovarian endometrioma (OMA) [12]
All four cases of malignant transformation (MT) during dienogest therapy (DNGT) were included in the “enlargement” group
Summary
To determine the prevalence of and risk factors for malignant transformation of ovarian endometrioma during dienogest therapy, which is very rare, we examined multiple cases of malignant transformation of ovarian endometrioma during dienogest therapy and performed a multivariate analysis of the records in our hospital. Endometriosis is among the most common gynecological diseases and is known to affect 2–10% of women of reproductive age [1, 2] This disease most commonly affects the ovaries, forming a cystic mass called an ovarian endometrioma (OMA) [3], and is diagnosed by an outpatient ultrasound examination. Honda et al Journal of Medical Case Reports (2019) 13:314 this risk factor has not been performed. Ovarian endometrioma is a subtype of endometriosis, affecting 17–44% of women with endometriosis [13] In most cases, this disease is diagnosed as endometrioma by an outpatient ultrasound examination [4], and laparoscopic surgeries are often performed to treat pelvic pain and subfertility [6]. Our analysis may provide new insight into preventing future cases of MT of OMA
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