A 56-year-old woman has had vaginal bleeding for 1 week. Her last menstrual period was 10 years ago. On physical examination, a lower abdominal mass is palpated. An endometrial biopsy is performed and shows endometrial carcinoma. An abdominal CT scan shows a 6-cm mass in the left ovary. A total abdominal hysterectomy is performed. Microscopically, the ovarian mass is a granulosa-theca cell tumor producing estrogen. Which of the following best describes the relationship between these two neoplasms?
Correct Answer: Promotion of carcinogenesis
Description: Estrogen, similar to many other hormones and drugs, by itself is not carcinogenic, but it is responsible for the stimulation of endometrial growth (hyperplasia), which has a promoting effect when cellular mutations occur to produce carcinoma. Inherited susceptibility can never be completely excluded when an individual has two tumors; this can occur in patients with inherited mutations in the p53 gene. In this case, however, there is a clear hormonal basis for the second tumor. Faulty tumor suppressor genes are not involved in the hormonal promotion of a neoplasm. A paraneoplastic syndrome results from ectopic secretion of a hormone by the tumor (e.g., lung cancer cells producing corticotropin). Tumor heterogeneity does not refer to two separate kinds of neoplasms; it refers to heterogeneity with a given tumor or metastasis.
Category:
Pathology
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