• Which came first, ovarian or endometrial?

    Asked by marie60 on Friday, February 8, 2013

    Which came first, ovarian or endometrial?

    I had a hysterectomy when an endo biopsy said I had clear cell cancer, but when they did the op, they found the same cancer in my left ovary. So I'm wondering which came first? And do I have ovarian cancer or endometrial cancer?

    4 Answers from the Community

    4 answers
    • nancyjac's Avatar

      From what you are saying, you have clear cell cancer that was found in two places. You have neither ovarian nor endometrial cancer, you have clear cell cancer aka clear cell adenocarcinoma.

      over 3 years ago
    • carm's Avatar
      carm (Best Answer!)

      What an great question to ask, and the answer really depends on your primary symptoms. Both Ovarian and Endometrial have sub-types of clear cell. I seriously doubt that you have 2 primaries. In endometrial cancer, clear cell is in the Type I category, and Type I is the more common of endometrial cancers. It is hormone driven and presents at late onset, usually around the age of 60. It is more common in overweight women only because the adipose (fat tissue), or adipocytes (fat tissue cells) have the ability to convert from androstenedione (a steroid hormone produced in the adrenal glands) to estrone, a weaker circulating estrogen. If, for example, a woman is 50 lbs overweight, her risk is 10 times that of a woman of normal weight of developing endometrial cancer. For ovarian cancer, clear cell is also hormone driven. In Ovarian, the World Health Organization Classification of Malignant Ovarian Tumors (DaVita, Lawrence & Rosenberg, 2008) classifies clear cell as a common epithelial tumor sub-type under the heading of Malignant Endometriod Tumors; so you can see the connection. As I said a lot depends on your presenting symptoms. If what alerted you to the problem was heavy menses that went on far too long, then chances are it started in the endometrium lining. If you were asymptomatic and your disease was found by accident, chances are that it started from the fallopian tubes/ovaries. Either case the treatment for clear cell is usually the same and gyne cancers have the propensity to follow the path of least resistance. In both cases it's the para-aortic lymph nodes in the upper abdomen. Both diseases also have a high rate of connection to the p53 gene mutation (Endometrial cancer 90%, Ovarian cancer >50%). I think only your pathologist can determine the origin. An endometrial biopsy (EMB) can only give you a picture of the cells on the endometrium. I'm sure they took a biopsy during the surgery to determine if other glands were affected, and it is that biopsy that trumps the EMB. Best of luck to you, Carm RN
      DeVita, V. T., Lawrence, T. S. & Rosenberg, S. A. (2008). Cancer: Principles & Practice of Oncology (8th ed.)
      Philadelphia, PA: Lippincott Williams & Wilkins Publishing.

      over 3 years ago
    • Cindy's Avatar

      You should ask your doctor. In my case, my doctor said I had Ovarian cancer in my left ovary that spread to my uterus. My pathology report says that I had a high-grade endometroid and clear cell carcinoma arising in ovarian endometriosis.

      over 3 years ago
    • lchapman2000's Avatar

      Hi Marie60, I too had endometrial cancer. When the pathology report was completed they found cancerous cells in one ovary and free floating in the cervix. My primary is endometrial cancer. My tumor was large and it is believed that these cells broke off the tumor itself before the surgery. Best of luck to you on your journey.

      Nancyjac, I am unsure why you keep answering questions that you clearly don't have answers to. I looked at your history and you have no history of endometrial cancer or any gynecological cancer. And from what I gather you have no medical training. So my question is what frame of reference do you have to give bad advice? I know that I, myself, and I am sure the others would prefer you simply not answer the questions that you not have a true frame of reference for. Furthermore, your comments are rather snippy and rude at times. Maybe you should find a different hobby. This is important for many people to find help and you could be causing harm.

      over 3 years ago

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