Insight into the mechanisms of endometriosis associated ovarian cancers development

Women suffering from endometriosis face a higher risk for cancer development in ectopic endometrial tissue sites, especially in ovaries. Malignant transformation of endometriotic lesions represents a well know phenomenon, but mechanisms involved remain not entirely understood. However, novel evidences have emerged, improving our understanding of this entity. Genetic alterations, including but not limited to loss of heterozygosity, gene mutations, chromosome amplifications, overexpression of oncogenes, inactivation of tumor suppressor genes, variations in regulating genes and post transcriptional regulation of gene’s expression, contribute to malignant transformation. Genetic instability is in linkage with multiple molecular processes, as production by heme and iron induced oxidative stress, local microenvironment with high concentrations of estrogens and recruitment of inflammation factors. This review summarizes the current knowledge of multileveled mechanisms potentially involved in the pathogenesis of endometriosis associated ovarian cancer.