Beware of “benign cancer” of the uterus

 Aunt Xu didn’t expect that the endometriosis that had been entangled with her for many years would bring big trouble again when she was about to menopause.
  Twenty years ago, Aunt Xu was still young because she had bilateral ovarian endometriotic cysts. She removed the fallopian tubes and ovaries on the right side, and removed the ovarian cysts on the left side. Ten years after the operation, Aunt Xu discovered a left ovarian cyst during the examination, which was only 3 cm in diameter at the time.

  Aunt Xu knows that endometriosis is “benign cancer.” Although it is called “cancer”, it is still benign at present, and Aunt Xu maintains the habit of annual review. But the cyst is gradually getting bigger. Until two years ago, after a strong abdominal pain, Aunt Xu hurried to the hospital for a B-ultrasound examination. The doctor found that the diameter of Aunt Xu’s left ovarian cyst had reached 8 cm! In addition to thick fluid, cysts also contain solid components, and ovarian tumor markers are also elevated. At this time, Aunt Xu had to undergo surgery.
  The doctor performed a radical resection of ovarian cancer for Aunt Xu, and the postoperative pathology was diagnosed as “clear cell carcinoma of the left ovary with endometrial cyst”. The “benign cyst” that had entangled Aunt Xu for many years turned into a “malignant tumor.”
  After 6 courses of chemotherapy, Aunt Xu now continues to follow up regularly, but because of the word “cancer” on the diagnosis report, Aunt Xu and her family are all in a shadow.
Endometriosis may still become cancerous

  Many women who suffer from endometriotic cysts know that endometriosis can cause dysmenorrhea, infertility, chronic pelvic pain and other symptoms, but it is rarely related to cancer that is discolored.
  Endometriosis is called “benign cancer”, and the malignant transformation rate is about 1%, but there is still the possibility of cancer. The main part of this kind of malignant transformation is in the ovary, and other parts of the malignant transformation are less, so it is called “endometriosis-related ovarian malignant tumor”.
  Current research shows that the most common histopathological type of ovarian malignant tumors caused by malignant transformation of endometriosis is Aunt Xu’s “clear cell carcinoma”, followed by “ovarian endometrioid carcinoma”, and a small amount “Poorly differentiated serous ovarian cancer.”

What are the signs of malignant change

  Pelvic mass. The main complaint of most patients is “pelvic mass”, and the examination is mostly cystic and solid mixed pelvic mass, and the mass increases rapidly.
  Discomfort in the lower abdomen. The main manifestations are lower abdominal distension and pain, falling pain, and dysmenorrhea. Progressive dysmenorrhea is a common symptom of endometriosis, but it is not typical in endometriosis-related ovarian malignancies.
  Increased menstrual flow, irregular vaginal bleeding or discharge, but this symptom is also not typical.
What to do if evil becomes “cancer”

  Pathology is the standard for diagnosis of malignant ovarian tumors related to endometriosis. Ultrasound, magnetic resonance, laboratory examination and other auxiliary diagnosis can also be used. Patients should be reviewed regularly and checked and treated by professional doctors.
  If malignant transformation does occur, the principle is the same as that of ordinary ovarian cancer. The initial treatment is mainly surgery, and supplemented by chemotherapy, radiotherapy, biological therapy, targeted therapy and other adjuvant treatments.
  Patients with endometriosis-related ovarian malignancies tend to be relatively young. The clinical stage is mainly stage I and II, and the cell differentiation is better. The prognosis is usually better than that of ovarian cancer patients with non-endometriosis-related ovarian malignancies.
Watch out for cancer signals

  The etiology of endometriosis-related ovarian malignancies is still unclear, so paying attention to the early diagnosis and treatment of endometriosis is the best strategy to prevent malignant transformation. Once the following situations occur, we must be particularly alert to the malignant changes of endometriosis:

  ●Patients with endometriosis after menopause have changes in the rhythm of pain.
  ●The ovarian cyst is too large, larger than 10 cm in diameter.
  ●Imaging examination revealed a solid or papillary structure inside the cyst. Color Doppler ultrasound indicated that the lesion had abundant blood flow and low resistance.
  ●The level of serum carbohydrate antigen 125 (CA125) is too high >200kU/L [levels higher than 200 thousand units (except infection or adenomyosis)].
  ●The onset of endometriosis is too early or the medical history is too long, especially when the diagnosis of ovarian endometriosis is at the age of 30 to 40 or the medical history is 10 to 15 years.