Difficulties in Differential Diagnosis of Benign and Malignant Ovarian Neoplasms Associated with Endometriosis

Aim. To present the literature data and clinical experience of the gynecologic oncology department of Russian Scientific Center of Roentgen Radiology, illustrating the difficulties in differential diagnosis of benign and malignant ovarian neoplasms associated with endometriosis. Key points. Significant difficulties in gynecology and gynecologic oncogynecology are caused timely differential diagnosis and choice of treatment tactics for ovarian neoplasms. This problem is caused by the lack of pathognomonic manifestations, low specificity and limited availability of diagnostic methods. Their high incidence and low five-year survival rate of women with ovarian cancer indicate the relevance of the problem of differential diagnosis and the subsequent tactics of management and treatment of patients with ovarian neoplasms. To date, careful attention has been paid to the relationship between endometriosis and the risk of malignant process, despite the fact that it is a benign proliferative diseases. The presence of a genetic link and histopathologic similarities allows us to consider endometriosis as a neoplastic process and consider it as a precursor of some forms of ovarian cancer, which should be taken into account for the correct verification of the diagnosis. Improvement of non-invasive diagnostic methods based on the combination of clinical picture, oncomarkers and imaging techniques with high informativeness is of scientific and practical interest. The article presents the literature data and clinical experience of the gynecologic oncology department of Russian Scientific Center of Roentgen Radiology, which are of interest from the point of view of patient management tactics and difficulties of differential diagnosis. Conclusion. Taking into account the high prevalence of external genital endometriosis, it is necessary to remember the possible risk of neoplastic transformation of endometrioid ovarian lesions and the development of oncologic process. Proper differential diagnosis of ovarian neoplasms associated with endometriosis requires a multiplex approach to choose the right treatment tactics. Keywords: ovarian masses, endometriosis, atypical endometriosis, endometrioid ovarian cancer, endometrioid cyst.