Endometriosis-associated endometrioid adenocarcinoma of the fallopian tube synchronized with endometrial adenocarcinoma:A case report

BACKGROUND Endometriosis is a common gynecological disorder that affects women of reproductive age.It is characterized by a cancer-like invasion of the extra-uterine endometrium and exhibits a strong association with ovarian clear cell cancer and endometrioid cancer.Endometriosis-associated fallopian tube endometrioid adenocarcinoma synchronized with endometrial adenocarcinoma was rarely reported.CASE SUMMARY A 49-year-old woman was referred to our hospital complaining about abnormal vaginal bleeding for three years following unsatisfactory medication.Intraop-erative frozen sections unexpectedly unveiled an endometrioid cancer of the left fallopian tube with superficial invasion surrounded by diffuse endometriosis synchronized with endometrioid endometrial cancer.CONCLUSION It was difficult to make a differential diagnosis when confronted with incidental findings of fallopian tube cancer lesions synchronized with endometrial cancer.The key differential diagnosis of primary endometriosis-associated endometrioid adenocarcinoma of the fallopian tube from endometrial adenocarcinoma invol-vement relies on the pathological identification of malignant transformation in fallopian tube endometriosis disease.

Immune pathway through endometriosis to ovarian cancer

Endometriosis is an estrogen-dependent inflammatory disease,defined by the presence of functional endometrial tissue outside of the uterine cavity.This disease is one of the main gynecological diseases,affecting around 10%-15%women and girls of reproductive age,being a common gynecologic disorder.Although endometriosis is a benign disease,it shares several characteristics with invasive cancer.Studies support that it has been linked with an increased chance of developing endometrial ovarian cancer,representing an earlier stage of neoplastic processes.This is particularly true for women with clear cell carcinoma,low-grade serous carcinoma and endometrioid.However,the carcinogenic pathways between both pathologies remain poorly understood.Current studies suggest a connection between endometriosis and endometriosis-associated ovarian cancers(EAOCs)via pathways associated with oxidative stress,inflammation,and hyperestrogenism.This article aims to review current data on the molecular events linked to the development of EAOCs from endometriosis,specifically focusing on the complex relationship between the immune response to endometriosis and cancer,including the molecular mechanisms and their ramifications.Examining recent developments in immunotherapy and their potential to boost the effectiveness of future treatments.

针刺治疗子宫内膜异位症相关性不孕:一项随机对照试验研究方案

Background:Acupuncture has been proven to improve the pregnancy rate in infertile women.Endometriosis is a common cause of infertility.So far,there are no studies of the efficacy of acupuncture on endometriosis-associated infertility(EAI).Therefore,we will conduct a randomized controlled trial(RCT)to investigate whether acupuncture could have higher pregnancy rates in patients with EAI compared with sham acupuncture.The study protocol is reported in this paper.Methods/design:The current trial is a multicenter randomized controlled study undergoing in Shanghai,China.About 224 eligible patients with EAI will be randomly assigned into the acupuncture group and the sham acupuncture group in a 1:1 ratio.In the acupuncture group,patients will be treated with acupuncture on Guanyuan(CV4),Zhongji(CV3),Zigong(EX-CA1),Xuehai(SP10),Zusanli(ST36),Sanyinjiao(SP6),and Taichong(LR3),twice a week,for 3 menstrual cycles,and 12 menstrual cycles will be followed up.The Park sham device will be used to perform non-transdermal acupuncture in the sham acupuncture group.The operation points will be located at 1.5 cm away beside these acupoints in the acupuncture group.The intervention period is the same as that in the acupuncture group.The primary outcome will be pregnancy rate.Secondary outcomes will include ultrasound results,cancer antigen 125(CA125),antiMullerian hormone(AMH),sex hormones,and the Endometriosis Health Profile-5(EHP-5).Outcomes will be collected at baseline,the end of treatment,and follow-up visits at 3,6,and 12 menstrual cycles.All data,including major adverse events,will be recorded in electronic case report forms and analyzed using SPSS V.25.0.Discussion:This study will help to evaluate whether acupuncture is effective in increasing the pregnancy rate of infertile women with endometriosis.