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The occurrence and histopathological recognition of atypical endometriosis in patients with ovarian endometriosis - a retrospective cohort study

  • 0Catharina Hospital Eindhoven, Netherlands; GROW School for Oncology and Developmental Biology, Netherlands.
Human Pathology +

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July 24, 2025

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July 24, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Atypical endometriosis (AE) diagnosis shows high variability among pathologists. Stricter criteria were developed to improve consistent identification of AE, a potential precursor to endometriosis-associated ovarian carcinoma.

Area Of Science

  • Gynecologic Pathology
  • Oncology
  • Histopathology

Background

  • Atypical endometriosis (AE) is a potential precursor to endometriosis-associated ovarian carcinoma (EAOC).
  • Current identification of AE lacks clinical implications and is not standard in histopathological examinations.
  • Variability in AE diagnosis hinders its clinical utility.

Purpose Of The Study

  • To determine interobserver variability in AE diagnosis.
  • To identify features for consistent AE identification.
  • To refine diagnostic criteria for AE.

Main Methods

  • Retrospective review of 266 ovarian endometrioma cases (1985-2017).
  • Two independent pathologists re-evaluated cases using predefined criteria.
  • Consensus meeting to resolve discrepancies and adjust criteria.

Main Results

  • Initial AE reports in 11.7% of cases.
  • Pathologists identified AE in 18% of cases, reduced to 7.1% after consensus.
  • Adjusted diagnostic criteria were established post-consensus.

Conclusions

  • High interobserver variability in AE diagnosis is evident.
  • Stricter, refined criteria are proposed for uniform AE identification.
  • Consistent AE documentation is crucial for understanding its link to malignant transformation.