The fallopian tube as the origin of non‐uterine pelvic high‐grade serous carcinoma

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 salping...

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Bibliographic Details
Published in:The obstetrician & gynaecologist 2016-04, Vol.18 (2), p.143-152
Main Authors: Aggarwal, Ieera Madan, Lim, Yu Hui, Lim, Timothy Yong Kuei
Format: Article
Language:English
Subjects:
fallopian tube cancers
Genital cancers
Gynecological cancer
high‐grade serous cancers
risk‐reducing salpingo‐oophorectomy
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Summary: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?
ISSN:1467-2561
1744-4667
DOI:10.1111/tog.12258