From deep infiltrating endometriosis to endometriosis-associated cancer: current aspects of differential diagnosis

Deep infiltrating endometriosis is a socially significant condition that markedly reduces patients’ quality of life due to chronic pain syndrome and a high risk of infertility. In recent years, increasing evidence has emerged regarding the malignant transformation of the disease, with the malignant foci developing predominantly in the ovaries, as well as in extra-ovarian locations. The similarity of clinical manifestations, morphological characteristics, and molecular alterations between benign and malignant disease forms markedly complicates differential diagnosis. This article summarizes current concepts regarding the criteria for distinguishing deep infiltrating endometriosis from endometriosis-associated cancer. It highlights the limited evidence base and the need to develop standardized integrative approaches to improve diagnostic accuracy and stratification of oncological risk in this group of patients.