Concomitant endometrioid carcinoma of the ovary and endometrial carcinoma of the uterus associated with adenocarcinoma in situ of the cervix.

Endometrioid carcinoma of the ovary is the third most common epithelial tumour of the ovary, accounting for between 16% and 25% of these tumours.1 A co-existing adenocarcinoma of the endometrium has been found in 14-25% of patients.2' 3 CASE REPORT A 45-year-old female, para 2, presented to the gynaecological outpatient clinic with a two-year history of menorrhagia. There was no intermenstrual or post-coital bleeding. General examination was satisfactory apart from obesity (94 kg). Vaginal examination revealed a slightly enlarged anteverted uterus with no obvious adnexal masses. The cervix appeared healthy. Haematological investigations were normal with no evidence of anaemia. A diagnostic curettage was performed and the histological examination showed adenomatous hyperplasia with no evidence of cellular atypia or malignancy. Following dietary advice the patient lost 18 kg weight. She was then admitted for an abdominal total hysterectomy because of continuing menorrhagia, further curettage six months after the initial curettage having shown adenomatous hyperplasia. At operation, the right ovary was unexpectedly enlarged (10cm diameter), multilocular with solid and cystic areas. The uterus was bulky but otherwise appeared normal. Abdominal total hysterectomy and bilateral salpingo-oophorectomy was performed. There was no evidence of metastatic disease in the omentum, liver or bowel. Histological examination of the right ovary showed a primary endometrioid adenocarcinoma. It was partially necrotic and moderately well differentiated. It had focally infiltrated the inner aspect of the capsule and residual ovarian cortex. The serosa was not involved. In the endometrial cavity there was a secretory phase endometrium and at one point a small focus of well differentiated adenocarcinoma. It had not infiltrated the myometrium. (The previous curettage