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The fallopian tube as the origin of non‐uterine pelvic high‐grade serous carcinoma
Author(s) -
Aggarwal Ieera Madan,
Lim Yu Hui,
Lim Timothy Yong Kuei
Publication year - 2016
Publication title -
the obstetrician and gynaecologist
Language(s) - English
Resource type - Journals
eISSN - 1744-4667
pISSN - 1467-2561
DOI - 10.1111/tog.12258
Subject(s) - salpingectomy , fallopian tube , serous carcinoma , medicine , serous fluid , hysterectomy , gynecology , ovarian cancer , obstetrics , pathology , pregnancy , cancer , ectopic pregnancy , biology , genetics
Key content Advances in histopathology, immunohistochemistry and molecular genetics have led to evidence that the fimbrial end of the fallopian tube may be the source of origin of non‐uterine high‐grade pelvic serous carcinoma (HGPSC). Most of the evidence comes from studies in risk‐reducing salpingo‐oophorectomy in BRCA carriers. A proportion of these high‐grade tumours have been proven to develop from specific precursor lesions, such as serous tubal intraepithelial carcinoma (STIC), before transformation into invasive high‐grade pelvic serous carcinoma. Detailed sectioning of the fallopian tube is suggested using the SEE‐FIM protocol (Sectioning and Extensively Examining the Fimbriated end of the fallopian tube). Clinical management of STIC in the absence of malignancy is not yet clearly defined.Learning objectives To review the various theories of pathogenesis of non‐uterine HGPSC. To discuss the clinical management of STIC. Preventative strategies for HGPSC.Ethical issues Role for salpingectomy as a mode of sterilisation in women with completed family and salpingectomy during hysterectomy for benign cases. Could risk‐reducing salpingectomy be recommended instead of risk‐reducing salpingo‐oophorectomy in young women, to avoid menopausal side effects?