Endometrial Cancer Arising in Adenomyosis (EC-AIA): A Systematic Review
Antonio Raffone, Diego Raimondo, Manuela Maletta, Antonio Travaglino, Federica Renzulli, Daniele Neola, Umberto De Laurentiis, Francesco De Laurentiis, Mohamed Mabrouk, Manuel Maria Ianieri, Renato Seracchioli, Paolo Casadio, Antonio Mollo
Abstract
Endometrial cancer arising in adenomyosis (EC-AIA) is a rare uterine disease characterized by the malignant transformation of the ectopic endometrium within the adenomyotic foci. Clinicopathological and survival data are mostly limited to case reports and a few cohort studies. We aimed to assess the clinicopathological features and survival outcomes of women with EC-AIA through a systematic review of the literature. Six electronic databases were searched, from 2002 to 2022, for all peer-reviewed studies that reported EC-AIA cases. Thirty-seven EC-AIA patients from 27 case reports and four case series were included in our study. In our analysis, EC-AIA appeared as a rare disease that mainly occurs in menopausal women, shares symptoms with endometrial cancer, and is challenging to diagnose preoperatively. Differently from EC, it shows a higher prevalence of the non-endometrioid histotype, advanced FIGO stages, and p53-signature, which might be responsible for its worse prognosis. Future studies are necessary, to confirm our findings and further investigate this rare condition.