Testosterone Aromatization to Estradiol in Course of Ovarian Functioning Brenner Tumor Associated With Endometrial Carcinoma and Endometriosis (Roncati-Manenti Triad). Issue 8 (1st October 2016)

• Record Type: Journal Article
• Authors: Roncati, Luca; Manenti, Antonio; Pusiol, Teresa; Piscioli, Francesco; Barbolini, Giuseppe; Maiorana, Antonio
• Is Part Of: International journal of gynecological cancer. Volume 26:Issue 8(2016)
• Page Start: 1461
• Page End: 1464
• Publication Date: 2016-10-01
• Subjects: Aromatization -- Hyperestrogenism -- Brenner tumor -- Endometrial endometrioid carcinoma -- Endometriosis -- Immunohistochemistry; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1097/IGC.0000000000000779
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objective: Aromatization is the biochemical process in which aromatase catalyzes the conversion of testosterone into estradiol, the fundamental pathway for the synthesis of estrogens. When enhanced, it can lead to hyperestrogenism, a well-known risk factor for gynecological cancers. Methods: The surgical specimens, coming from 2 postmenopausal women with hyperestrogenism on pap smear and bioptic diagnosis of endometrial endometrioid carcinoma, were fixed in 10% neutral buffered formalin, paraffin embedded, and then submitted for routine hematoxylin/eosin staining and immunohistochemical characterization for antiestrogen, antiprogesterone, antitesterone, anti-MLH1, anti-PMS2, anti-MSH2, and anti-MSH6. Results: The presence of an undescribed triad represented by ovarian functioning Brenner tumor, endometrial carcinoma, and pelvic endometriosis has been ascertained. The immunohistochemical investigation proved a normal expression of the DNA mismatch repair proteins and revealed a bimodal hormonal status in the pathological tissues, that is, the Brenner tumor cells showed a high expression of testosterone, contrariwise endometrioid carcinoma and endometriosis a high estrogen and progesterone immunolabeling. Conclusions: This synchronous triad underlines the importance of aromatization and hyperestrogenism in the development of gynecological malignancies in which the immunohistochemical detection of an active source of hormone production — to always keep in consideration during synchronous diseases — can guide subsequent antihormone chemotherapy based on aromatase inhibitors.