medigraphic.com
Federación Mexicana de Ginecología y Obstetricia, A.C.

2020, Number 09

<< Back Next >>

Ginecol Obstet Mex 2020; 88 (09)

Seuous tubal intraepithelial carcinoma as a post-surgical finding of endometriosis and myomatous uterus. A case report

Luque-González P, Requerey-Fernández M, Frías-Sánchez Z, Guadix-Martín MP, Jiménez-Caraballo A, Gutiérrez-Domingo Á, Pantoja-Garrido M

Language: Spanish
References: 13
Page: 625-631
PDF size: 435.51 Kb.


ABSTRACT

Background: Serous tubal intraepithelial carcinoma (STIC) is a precursor lesion of invasive high-grade tubal and serous carcinoma of the ovary, frequently diagnosed in the context of prophylactic bilateral salpingoophorectomy for benign gynecological pathology. The objective of this work is to carry out a literature review on the most relevant aspects of the follow-up of this injury, after its incidental diagnosis in gynecological surgery.
Clinic case: A 51-year-old nulliparous patient who, in the context of a clinical situation of abdominal pain with elevation of tumor markers CA125 and CA19.9, was diagnosed with polymomatous uterus and suspected endometrioma in the right ovary. After a subtotal hysterectomy with bilateral adnexectomy, the histological study of the excised tubal specimen found microscopic foci of STIC without signs of stromal invasion. Given this finding, breast imaging tests and a genetic study of the BRCA 1/2 mutation was requested.
Conclusion: Prophylactic bilateral salpingoophorectomy in gynecological surgery is a procedure that can reduce the risk of developing peritoneal, tubal, and serous ovarian carcinomas. Patients diagnosed with STIC should be subsidiaries of follow-up based on ultrasound controls, mammary imaging tests, tumor markers, and genetic studies, due to their association in many cases with mutations in the BRCA 1/2 genes. It is necessary to establish a series of standardized clinical protocols for the management of patients with STIC and to continue advancing our understanding of this pathology and its subsequent evolution to high-grade serous carcinoma.


REFERENCES

  1. Gutkin DW, et al. Novel protein and immune response markers of human serous tubal intraepithelial carcinoma of the ovary. Cancer Biomark. 2019;26(4):471-479. doi: 10.3233/ CBM-190528.

  2. Zhang S, et al. Both fallopian tube and ovarian surface epithelium are cells-of-origin for high-grade serous ovarian carcinoma. Nat Commun. 2019;10(1):5367. doi: 10.1038/ s41467-019-13116-2.

  3. Stewart ME, et al. Evaluation of screening and risk-reducing surgery for women followed in a high-risk breast/ovarian cancer clinic: it is all about the tubes in BRCA mutation carriers. Gynecol Oncol Rep. 2019; 28: 18-22. doi: 10.1016/j. gore.2019.01.010.

  4. Stanciu PI, et al. Development of peritoneal carcinoma in women diagnosed with serous tubal intraepithelial carcinoma (STIC) following risk-reducing salpingo-oophorectomy (RRSO). J Ovarian Res. 2019; 12: 50. doi: 10.1186/s13048- 019-0525-1.

  5. Arora S, et al. Evaluation of SEE-FIM (Sectioning and Extensively Examining the FIMbriated End) protocol in identifying fallopian tube precursor lesions in women with ovarian tumors. J Obstet Gynaecol India. 2019; 69 (2): 153-59. doi: 10.1007/s13224-018-1155-z.

  6. Kaur H, et al. Papillary syncytial metaplasia of fallopian tube endometriosis: a potential pitfall in the diagnosis of serous tubal intraepithelial carcinoma. Arch Pathol Lab Med. 2013; 137 (1): 126-9. doi: 10.5858/ arpa.2011-0312-CR.

  7. Seidman JD, et al. High-grade pelvic serous carcinoma within the fallopian tube lumen: real or artifact? Int J Gynecol Pathol. 2019.. doi: 10.1097/PGP.0000000000000649.

  8. Rojo-Novo S, et al. Displasia epitelial tubárica de alto grado tras anexectomía bilateral profiláctica por cáncer de mama, en paciente con mutación en el gen BRCA1. Rev Obstet Ginecolog Venez. 2018; 78 (2): 157-64. doi: 10.4067/s0717- 75262018000200182.

  9. Meserve EEK, et al. Frequency of incidental serous tubal intraepithelial carcinoma (STIC) in women without a history of or genetic risk factor for high-grade serous carcinoma: A six-year study. Gynecol Oncol. 2017; 146 (1): 69-73. doi: 10.1016/j.ygyno.2017.04.015.

  10. Gilks CB, et al. Incidental nonuterine high-grade serous carcinomas arise in the fallopian tube in most cases: further evidence for the tubal origin of high-grade serous carcinomas. Am J Surg Pathol. 2015; 39 (3): 357-64. doi: 10.1097/pas.0000000000000353.

  11. Samimi G, et al. Population frequency of serous tubal intraepithelial carcinoma (STIC) in clinical practice using SEE-Fim Protocol. JNCI Cancer Spectrum 2018; 2 (4): pky061. doi: 10.1093/jncics/pky061.

  12. Visvanathan K, et al. Fallopian tube lesions in women at high risk for ovarian cancer: a multicenter study. Cancer Prev Res (Phila). 2018; 11 (11): 697-706. doi: 10.1158/1940- 6207.

  13. Wong JWH, et al. Completeness of salpingectomy intended for ovarian cancer risk reduction. Gynecol Oncol. 2019; 155 (2): 280-82. doi: 10.1016/j.ygyno.2019.09.005.




2020     |     www.medigraphic.com