Mardi Kavita, Goyal Kanav, Jagota Arnav
Pathology, Indira Gandhi Medical College, Shimla, IND.
Cureus. 2025 Aug 22;17(8):e90715. doi: 10.7759/cureus.90715. eCollection 2025 Aug.
Adenomyosis often coexists with endometriosis, which primarily involves the ovary and can lead to endometriosis‑associated ovarian cancers, most commonly endometrioid and clear‑cell carcinomas. Ovarian squamous cell carcinoma (OSCC) arising in endometriosis is exceedingly rare, lacks established treatment guidelines, and carries a poor prognosis despite only sporadic reports in the literature. We describe a 45‑year‑old multiparous woman with a three‑month history of abnormal uterine bleeding. Speculum examination revealed a bleeding polypoid cervical mass, and transvaginal ultrasound confirmed adenomyosis. Persistent bleeding refractory to polypectomy and resultant severe anemia prompted total abdominal hysterectomy with bilateral salpingo‑oophorectomy. Unexpected histopathology and immunohistochemistry revealed a primary, poorly differentiated OSCC of the left ovary arising from endometriosis, extending into the left fallopian tube; the uterus, cervix, right adnexa, and ovarian capsule were uninvolved. The tumor was staged International Federation of Gynecology and Obstetrics IIA, and the patient received six cycles of carboplatin plus paclitaxel. At 15 months postoperatively, she remains disease‑free. This case underscores how adenomyosis can mask an underlying ovarian malignancy and illustrates the rare occurrence of OSCC in endometriosis. Awareness of such presentations should prompt thorough histological evaluation, and we emphasize the urgent need to develop treatment protocols for rare, aggressive histotypes. We also review the existing literature to contextualize this uncommon pathology and its clinical implications.
子宫腺肌病常与子宫内膜异位症并存，后者主要累及卵巢，可导致与子宫内膜异位症相关的卵巢癌，最常见的是子宫内膜样癌和透明细胞癌。子宫内膜异位症中发生的卵巢鳞状细胞癌（OSCC）极为罕见，缺乏既定的治疗指南，尽管文献中仅有零星报道，但预后较差。我们描述了一名45岁经产妇，有三个月异常子宫出血史。窥器检查发现宫颈有一个出血性息肉样肿物，经阴道超声证实有子宫腺肌病。息肉切除术后持续出血且难以控制，导致严重贫血，促使患者接受了全腹子宫切除术及双侧输卵管卵巢切除术。意外的组织病理学和免疫组化结果显示，左侧卵巢原发性低分化OSCC起源于子宫内膜异位症，已延伸至左侧输卵管；子宫、宫颈、右侧附件和卵巢包膜未受累。肿瘤分期为国际妇产科联盟IIA期，患者接受了六个周期的卡铂加紫杉醇治疗。术后15个月，她仍无疾病复发。该病例强调了子宫腺肌病如何掩盖潜在的卵巢恶性肿瘤，并说明了子宫内膜异位症中OSCC的罕见发生情况。认识到这种表现应促使进行全面的组织学评估，我们强调迫切需要为罕见的侵袭性组织学类型制定治疗方案。我们还回顾了现有文献，以了解这种罕见病理及其临床意义。
