{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T20:05:30Z","timestamp":1776197130725,"version":"3.50.1"},"reference-count":89,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T00:00:00Z","timestamp":1711497600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Endometriosis affects more than 10% of reproductive-aged women, causing pelvic pain and infertility. Despite the benign nature of endometriosis, ovarian endometriomas carry a higher risk of developing endometrioid carcinomas (EnOCs) and clear cell ovarian carcinomas (CCCs). Atypical endometriosis, defined as cytological atypia resembling intraepithelial cancer, is considered the precursor of endometriosis-associated ovarian cancer (EAOC). This narrative review aims to provide an overview of EAOC, proposing a practical approach to clinical and therapeutic decision making. Methods: An electronic literature search was conducted from inception up to January 2023, using the MEDLINE database via PubMed to evaluate the existing literature on EAOC, including its pathogenesis, the diagnostic process, and the therapeutic possibilities, with articles not relevant to the topic or lacking scientific merit being excluded. Results: Eighty-one articles were included in the review to present the current state of the art regarding EAOC. A pragmatic clinical flowchart is proposed to guide therapeutic decisions and improve patient outcomes. Conclusions: Endometriosis patients may have an increased risk of developing EAOC (either EnOC or CCC). Despite not being fully accepted, the concept of AE may reshape the endometriosis\u2013ovarian cancer relationship. Further research is needed to understand the unaddressed issues.<\/jats:p>","DOI":"10.3390\/jcm13071933","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T12:41:57Z","timestamp":1711543317000},"page":"1933","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Endometriosis-Related Ovarian Cancer: Where Are We Now? A Narrative Review towards a Pragmatic Approach"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6113-7401","authenticated-orcid":false,"given":"Gabriele","family":"Centini","sequence":"first","affiliation":[{"name":"Department of Molecular and Developmental Medicine, Obstetrics and Gynecological Clinic, University of Siena, 53100 Siena, Italy"}]},{"given":"Giorgia","family":"Schettini","sequence":"additional","affiliation":[{"name":"Department of Molecular and Developmental Medicine, Obstetrics and Gynecological Clinic, University of Siena, 53100 Siena, Italy"}]},{"given":"Emilio","family":"Pieri","sequence":"additional","affiliation":[{"name":"Department of Molecular and Developmental Medicine, Obstetrics and Gynecological Clinic, University of Siena, 53100 Siena, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7515-5782","authenticated-orcid":false,"given":"Matteo","family":"Giorgi","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Gynecological Unit, Valdarno Hospital, 52025 Montevarchi, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9513-1980","authenticated-orcid":false,"given":"Lucia","family":"Lazzeri","sequence":"additional","affiliation":[{"name":"Department of Molecular and Developmental Medicine, Obstetrics and Gynecological Clinic, University of Siena, 53100 Siena, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0756-535X","authenticated-orcid":false,"given":"Francesco Giuseppe","family":"Martire","sequence":"additional","affiliation":[{"name":"Department of Molecular and Developmental Medicine, Obstetrics and Gynecological Clinic, University of Siena, 53100 Siena, Italy"},{"name":"Department of Surgical Sciences, Gynecological Unit, University of Rome \u201cTor Vergata\u201d, 00133 Rome, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4775-3777","authenticated-orcid":false,"given":"Virginia","family":"Mancini","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnology, Section of Pathology, University of Siena, 53100 Siena, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3235-4378","authenticated-orcid":false,"given":"Diego","family":"Raimondo","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"}]},{"given":"Renato","family":"Seracchioli","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"},{"name":"Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3263-553X","authenticated-orcid":false,"given":"Nassir","family":"Habib","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Francois Quesnay Hospital, 78201 Mantes-la-Jolie, France"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8202-748X","authenticated-orcid":false,"given":"Francesco","family":"Fedele","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Fondazione \u201cPoliclinico-Mangiagalli-Regina Elena\u201d University of Milan, 20122 Milan, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0735-6301","authenticated-orcid":false,"given":"Errico","family":"Zupi","sequence":"additional","affiliation":[{"name":"Department of Molecular and Developmental Medicine, Obstetrics and Gynecological Clinic, University of Siena, 53100 Siena, Italy"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"27","DOI":"10.5301\/JE.5000148","article-title":"Chronic Pelvic Pain and Quality of Life in Women with and without Endometriosis","volume":"5","author":"Centini","year":"2013","journal-title":"J. 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