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Endosalpingiosis and gynecological cancers

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Dr. Anita Kant, Chairman & Head Department of Gynae & Obstetrics, Asian Institute of Medical Sciences, Faridabad    09 August 2022

About 40% of women with endosalpingiosis also had some gynecological malignancy compared to women with endometriosis, suggests a recent retrospective case-control study published in the journal Gynecologic Oncology.1 The overall survival was also less in the endosalpingiosis group.

To investigate the association between endosalpingiosis and coexisting gynecologic malignancy, researchers analysed data from 515 cases of histologically diagnosed endosalpingiosis and 452 matched cases of endometriosis obtained from medical records at three academic hospitals in the United States from 2000 to 2020. The points of difference between the two groups were that women with endosalpingiosis were much older (52 years) than those with endometriosis (48 years). More women in the endosalpingiosis group had known genetic mutations compared to the endometriosis group; 3.9% vs 2.2%, respectively. But chronic pain was more prevalent in women with endometriosis (47%) compared to women with endosalpingiosis (28.4%).

The incidence of cancer was 2.5-times higher in the endosalpingiosis group vs the endometriosis group with an odds ratio of 2.48. Forty percent of patients with endosalpingiosis were also diagnosed at surgery as having concurrent cancer compared to 18% of patients with endometriosis. This association between endosalpingiosis and cancer remained significant when patients with known or suspected malignancy were excluded from the analysis; 20.9% vs 5.6%, respectively. The overall survival was lower in endosalpingiosis patients; 77% were alive at 10 years after the diagnosis vs 90.5% in the endometriosis group with odds ratio of 1.69. More than 90% of malignancies in women with endosalpingiosis as well as endometriosis were ovarian and uterine cancers.

Endosalpingiosis is the presence of ectopic fallopian tube-like epithelium outside the fallopian tube. It is an incidental finding during surgery for other gynecological problems. It is a rare benign condition and may be erroneously diagnosed as malignancy due to lack of awareness and understanding about the condition.2 Many studies have hinted at its association with gynecologic cancers, as also this study. But, it is not known yet if endosalpingiosis is a premalignant condition though in this study patients with endosalpingiosis were twice as likely to have concurrent cancer compared to those with endometriosis. The researchers call upon further research to analyse this interrelationship.

References

  1. Lewis GK, et al. The association of endosalpingiosis with gynecologic malignancy. Gynecol Oncol. 2022 Jul 28:S0090-8258(22)00510-8. doi: 10.1016/j.ygyno.2022.07.025.
  2. Ahmed Samy El-Agwany. Endosalpingiosis (a rare pathology that mimic others): Could it be a precursor of cancer? Indian J Gynecol Oncolog. 2016;14:47.

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