Moraru Liviu, Mitranovici Melinda-Ildiko, Chiorean Diana Maria, Moraru Raluca, Caravia Laura, Tiron Andreea Taisia, Cotoi Ovidiu Simion
Department of Anatomy, "George Emil Palade" University of Medicine, Pharmacy, Sciences and Technology, 540142 Targu Mures, Romania.
Department of Obstetrics and Gynecology, Emergency County Hospital Hunedoara, 14 Victoriei Street, 331057 Hunedoara, Romania.
Diagnostics (Basel). 2023 May 28;13(11):1883. doi: 10.3390/diagnostics13111883.
Cancer arising from adenomyosis is very rare, with transformation occurring in only 1% of cases and in older individuals. Adenomyosis, endometriosis and cancers may share a common pathogenic mechanism that includes hormonal factors, genetic predisposition, growth factors, inflammation, immune system dysregulation, environmental factors and oxidative stress. Endometriosis and adenomyosis both exhibit malignant behaviour. The most common risk factor for malignant transformation is prolonged exposure to oestrogens. The golden standard for diagnosis is histopathology. Colman and Rosenthal emphasised the most important characteristics in adenomyosis-associated cancer. Kumar and Anderson emphasised the importance of demonstrating a transition between benign and malignant endometrial glands in cancer arising from adenomyosis. As it is very rare, it is difficult to standardize treatment. In this manuscript, we try to emphasize some aspects regarding the management strategy, as well as how heterogenous the studies from the literature are in terms of prognosis in both cancers that develop from adenomyosis or those that are only associated with adenomyosis. The pathogenic mechanisms of transformation remain unclear. As these types of cancer are so rare, there is no standardised treatment. A novel target in the diagnosis and treatment of gynaecological malignancies associated with adenomyosis is also being studied for the development of new therapeutic concepts.
子宫腺肌病相关癌症非常罕见，仅1%的病例会发生恶变，且多发生于老年个体。子宫腺肌病、子宫内膜异位症和癌症可能具有共同的致病机制，包括激素因素、遗传易感性、生长因子、炎症、免疫系统失调、环境因素和氧化应激。子宫内膜异位症和子宫腺肌病都具有恶性行为。恶变的最常见危险因素是长期暴露于雌激素。诊断的金标准是组织病理学。科尔曼和罗森塔尔强调了子宫腺肌病相关癌症的最重要特征。库马尔和安德森强调了在子宫腺肌病相关癌症中显示良性和恶性子宫内膜腺体之间过渡的重要性。由于其非常罕见，难以标准化治疗。在本手稿中，我们试图强调管理策略的一些方面，以及文献中关于子宫腺肌病相关癌症或仅与子宫腺肌病相关癌症预后的研究差异有多大。恶变的致病机制仍不清楚。由于这类癌症非常罕见，尚无标准化治疗方法。与子宫腺肌病相关的妇科恶性肿瘤诊断和治疗的新靶点也在研究中，以开发新的治疗理念。
