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J Natl Cancer Inst. 2016 Feb 1;108(6):djv428. doi: 10.1093/jnci/djv428. Print 2016 Jun.

Synchronous Endometrial and Ovarian Carcinomas: Evidence of Clonality.

Author information

1
Department of Pathology and Laboratory Medicine, (MSA, HMH, JS, HLC, ANK, BSS, MKM, CBG, SK, DGH) and Department of Obstetrics and Gynaecology (MSA, DGH), University of British Columbia, Vancouver, Canada; Department of Molecular Oncology, British Columbia Cancer Agency Cancer Research Centre, Vancouver, Canada (YKW, AB, RM, DSG, SPS); Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany (MM, FAT, DW, SB, SK); Division of Anatomic Pathology, Synlab MVZ, Institute of Pathology, Mannheim, Germany (FK); Division of Gynecologic Pathology, Institute of Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (AS); Department of Anatomical Pathology, Vancouver General Hospital, Vancouver, Canada (CBG).
2
Department of Pathology and Laboratory Medicine, (MSA, HMH, JS, HLC, ANK, BSS, MKM, CBG, SK, DGH) and Department of Obstetrics and Gynaecology (MSA, DGH), University of British Columbia, Vancouver, Canada; Department of Molecular Oncology, British Columbia Cancer Agency Cancer Research Centre, Vancouver, Canada (YKW, AB, RM, DSG, SPS); Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany (MM, FAT, DW, SB, SK); Division of Anatomic Pathology, Synlab MVZ, Institute of Pathology, Mannheim, Germany (FK); Division of Gynecologic Pathology, Institute of Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (AS); Department of Anatomical Pathology, Vancouver General Hospital, Vancouver, Canada (CBG). dhuntma@bccancer.bc.ca.

Abstract

Many women with ovarian endometrioid carcinoma present with concurrent endometrial carcinoma. Organ-confined and low-grade synchronous endometrial and ovarian tumors (SEOs) clinically behave as independent primary tumors rather than a single advanced-stage carcinoma. We used 18 SEOs to investigate the ancestral relationship between the endometrial and ovarian components. Based on both targeted and exome sequencing, 17 of 18 patient cases of simultaneous cancer of the endometrium and ovary from our series showed evidence of a clonal relationship, ie, primary tumor and metastasis. Eleven patient cases fulfilled clinicopathological criteria that would lead to classification as independent endometrial and ovarian primary carcinomas, including being of FIGO stage T1a/1A, with organ-restricted growth and without surface involvement; 10 of 11 of these cases showed evidence of clonality. Our observations suggest that the disseminating cells amongst SEOs are restricted to physically accessible and microenvironment-compatible sites yet remain indolent, without the capacity for further dissemination.

PMID:
26832771
DOI:
10.1093/jnci/djv428
[Indexed for MEDLINE]

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