The fallopian tube is the culprit and an accomplice in type II ovarian cancer: A review

Ovarian cancer is the most lethal gynecologic malignancy in the world. The origin or the pathogenesis of epithelial ovarian cancer is poorly understood, which often leads to failure of early detection. Development of a new approach to reduce mortality is urgent. The fallopian tubes were once seen as an extremely rare site for cancer, but increasing evidence now suggests that they could be involved in initiation of the most aggressive ovarian carcinoma. As a result of evolution to prevent ectopic pregnancy, not only is the fallopian tube “poor soil” for carcinogenesis, but angiogenesis is also inhibited there. However, every cycle of ovulation results in changes in which tubal epithelial cells are dislodged and implanted on the denuded surface of the ovary, resulting in the formation of an inclusion cyst. This is the very beginning of serous ovarian carcinogenesis. To prevent ovarian cancer, a salpingectomy might be recommended during hysterectomy because this procedure can effectively reduce the incidence of ovarian cancer. Application of these new concepts will allow for a more rational approach to screening, treatment, and prevention, which could potentially have a significant impact in reducing mortality from this devastating disease