Abstract
BackgroundMalignant transformation of endometriosis in extraovarian sites remains rare. Furthermore, the process is not definitely understood.Case presentationHerein, we report the case of a 40-year-old premenopausal nulligravida woman who presented with vaginal bleeding and who was finally diagnosed with a vaginal cancer originating from endometriosis and with a synchronous endometrial cancer. A gynecologic examination revealed a multiple polypoid mass on the posterior vaginal fornix. Magnetic Resonance Imaging of the pelvis showed two masses abutting respectively on the anterior uterine wall, and in the rectovaginal septum. The patient underwent a total laparoscopic excision of the rectovaginal mass, radical hysterectomy and low anterior resection of the rectum. The lesions were diagnosed as endometriosis, endometriosis-associated complex hyperplasia and endometrioid cancer. Furthermore, a synchronous endometrioid endometrial cancer was reported.ConclusionsThis case revealed the multistep process of malignant transformation of deep infiltrating endometriosis. The progression was individualized between implantation sites and in the same organ.
Highlights
Malignant transformation of endometriosis in extraovarian sites remains rare
It can rarely be presenting as vaginal mass and vaginal endometriosis is difficult to diagnosis [4, 5]
Since the hormonal milieu may influence the pathogenesis of these two diseases, women with endometriosis have an increased risk of subsequent endometrial cancer [11]
Summary
This case revealed the multistep process of malignant transformation of deep infiltrating endometriosis.
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