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Malignant transformation of benign endometriosis into endometriosis-associated neoplasms is rare, yet the underlying physiopathology is complex and debated. Endometrioid carcinoma and clear cell carcinoma represent the main histological subtypes. This pictorial review summarizes key MRI imaging characteristics suggesting ovarian or extra-ovarian endometriosis-related tumors, relevant for surgical planning.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/pictorial-essay-mri-evaluation-of-endometriosis-associated-neoplasms/386248/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/pictorial-essay-mri-evaluation-of-endometriosis-associated-neoplasms/386248.png","ImageObject",300,407,{"name":92,"@type":93},"Rizky","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-28","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":19},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"How common is the malignant transformation of endometriosis, according to the document?","Question",{"text":112,"@type":113},"Transformation of benign endometriosis to endometriosis-associated neoplasms is rare, with an estimated prevalence of less than 1%.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Why is MRI considered useful in this context?",{"text":117,"@type":113},"MRI is useful for displaying endometriosis lesions associated with an ovarian tumor and for raising suspicion of endometriosis-associated neoplasms.",{"name":119,"@type":110,"acceptedAnswer":120},"Which histological subtypes are highlighted as the main types?",{"text":121,"@type":113},"Endometrioid carcinoma and clear cell carcinoma are presented as the main histological subtypes.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},386248,1790319700,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":19,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},962085564807,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Radzynski et al. Insights into Imaging (2023) 14:144  \n[https://doi.org/10.1186/s13244-023-01485-8](https://doi.org/10.1186/s13244-023-01485-8)  \nEDUCATIONAL REVIEW Open Access  \nPictorial essay: MRI evaluation  \nof endometriosis-associated neoplasms  \nLouise Radzynski1* , Louis Boyer 1, Myriam Kossai2, Anne Mouraire2 and Pierre‑François Montoriol3  \nAbstract  \nEndometriosis is a frequent pathology mostly affecting women of young age. When typical aspects are present, the diagnosis can easily be made at imaging, especially at MRI. Transformation of benign endometriosis to endometri‑ osis‑associated neoplasms is rare. The physiopathology is complex and remains controversial. Endometrioid carci‑ noma and clear cell carcinoma are the main histological subtypes. Our goal was to review the main imaging charac‑ teristics that should point to an ovarian or extra‑ovarian endometriosis‑related tumor, especially at MRI, as it may be relevant prior to surgical management.  \nKey points  \n• Transformation of benign endometriosis to endometriosis‑associated neoplasms is rare.  \n• MRI is useful when displaying endometriosis lesions associated to an ovarian tumor.  \n• Subtraction imaging should be used in the evaluation of complex endometriomas.  \nKeywords Endometriosis, Neoplasm, MRI, Endometrioid carcinoma, Clear cell carcinoma  \nIntroduction  \nEndometriosis is a condition characterized by the growth of functional ectopic endometrial glands and stroma outside the uterus. It is a frequent and still underestimated disease, affecting about one in ten women in their reproductive years [1] but also older women following menopause [2].  \nMalignant transformation of endometriosis is deemed extremely rare, with an estimated prevalence of less than 1%[3].  \nAs a tertiary center specialized in gynecological oncology, we encounter cases of endometriosis-associated  \n*Correspondence:  \nLouise Radzynski [louise.radzynski@gmail.com](louise.radzynski@gmail.com)  \n1 Department of Radiology, University Hospital of Clermont‑Ferrand, Clermont‑Ferrand, France  \n2 Department of Pathology, Cancer Center of Clermont‑Ferrand, Clermont‑Ferrand, France  \n3 Department of Radiology, Cancer Center of Clermont‑Ferrand, Clermont‑Ferrand, France  \nmalignancy on a regular basis. The aim of this pictorial essay is to provide the key features which enable radiologists to raise a suspicion of endometriosis-associated neoplasms at magnetic resonance imaging (MRI).  \nEndometriosis and associated neoplasms  \nEndometriosis is a benign disease. Nevertheless, this condition shares some characteristics with malignant neoplasms, such as development of local and distant foci and attachment to or invasion of other tissues, with subsequent damage to the target organs. Furthermore, endometriosis exhibits recurrence, unregulated cell proliferation, and estrogen-dependent growth [4] . Endometriotic epithelial cells have a higher turnover than their stromal counterpart due to cyclic bleeding and have much higher mutation frequencies. Recent studies have shown that endometriosis lesions carry mutations similar to those of cancer cells [5] . Endometriosis-associated neoplasms encounter molecular abnormalities including the activation of the oncogenic KRAS and PI3K pathways and inactivation of tumor  \n© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the p","cbCaifyg7gSq9ENf","https://ap.wps.com/l/cbCaifyg7gSq9ENf","pdf",13885871,13,"English","# Abstract\n# Key points\n# Keywords\n# Introduction\n# Endometriosis and associated neoplasms\n# Imaging features","[{\"question\":\"How common is the malignant transformation of endometriosis, according to the document?\",\"answer\":\"Transformation of benign endometriosis to endometriosis-associated neoplasms is rare, with an estimated prevalence of less than 1%.\"},{\"question\":\"Why is MRI considered useful in this context?\",\"answer\":\"MRI is useful for displaying endometriosis lesions associated with an ovarian tumor and for raising suspicion of endometriosis-associated neoplasms.\"},{\"question\":\"Which histological subtypes are highlighted as the main types?\",\"answer\":\"Endometrioid carcinoma and clear cell carcinoma are presented as the main histological subtypes.\"}]","Pictorial essay: MRI evaluation of endometriosis-associated neoplasms | PDF",1790272922,33]