Synchronous primary endometrial and ovarian cancers: how to diagnose, differentiate and treat in the light of recent available literature data

Abstract

SEO – synchronous endometrial ovarian cancer is a well-known phenomenon, which has for years been managed as two primary independent cancers. The results of recent molecular studies, especially next-generation sequencing, suggest that the condition should be regarded as a continuum, with its origin probably lying in the endometrium or endometrial foci. It has been found that 0.7% to 1.0% of endometriosis patients may develop malignant lesions. Although SEO is being increasingly studied, diagnostics and treatment still leave many questions. The most important thing is to improve the diagnosis with rapid and simple detection. A few molecular methods are already known, but genetic diagnostic, still remains unclear. Old criteria implemented by Scully in 1998 should be nowadays complemented by immunohistochemical staining of estrogen and progestin receptors, bcl2 antibodies and molecular analyses of genes: B-catenin, PTEN, KRAS, TP53, PIK3CA and microsatellite instability. Will genetic diagnostics preserve fertility in young patients with SEO? This paper reviews relevant literature to determine a strategy for distinguishing between SEO and metastatic cancers, and presents management options for patients with SEO.