Article

High Rates of Occult Fallopian Tube Cancer Diagnosed at Prophylactic Bilateral Salpingo-Oophorectomy

Department of Obstetrics and Gynecology, Royal North Shore Hospital, Sydney, Australia.
International Journal of Gynecological Cancer (Impact Factor: 1.95). 08/2009; 19(5):826-9. DOI: 10.1111/IGC.0b013e3181a1b5dc
Source: PubMed

ABSTRACT

To determine the rate of occult malignancy in patients undergoing prophylactic bilateral salpingo-oophorectomy in Northern Sydney.
A retrospective case series of 45 consecutive patients who underwent prophylactic bilateral salpingo-oophorectomy between 2004 and March 2008.
Five (11%) cases of occult neoplasia were found in 45 patients. This included 3 cases of micro-invasive serous carcinoma of the fallopian tube, 1 case of in situ carcinoma in the fallopian tube and 1 case of metastatic breast cancer in the ovary. All cases of primary neoplasia were in the fimbrial end of the fallopian tube.
The importance of complete removal of the fallopian tubes and ovaries and the rigorous systematic pathological examination of these specimens are demonstrated in this case series. It supports emerging evidence that the fimbrial end of the fallopian tube is an important site of genesis of cancer in BRCA1/2 mutation carriers.

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    • "Les trompes de cancers ovariens séreux de haut grade sporadiques (sans mutation génétique BRCA et non associés à un syndrome de Lynch) ont alors été réexaminées à la recherche de lésions tubaires prénéoplasiques : une séquence identique a été mise en évidence mais, dans une proportion moins importante (30 à 50 % de lésions STICs) [17] [18] [19] [20] [21] [22]. Le fait que ces lésions tubaires précèdent le cancer invasif peut être affirmé par : présence de STICs sans cancer ovarien sur les annexectomies prophylactiques pour risque génétique [7] [8] [9] [10] [11] [12] ; profils moléculaires identiques entre STILs, STICs et cancers invasifs : mutations identiques du TP53 dans 93 % des cas [23], surexpression des gênes RSF-1, Cycline E, p16, FASN, stathmine (marqueur de la voie de signalisation PI3K), laminine g 1, suggérant une expansion clonale à partir des lésions tubaires [24] [25] ; présence de cellules souches électivement localisées au niveau de la partie distale de la trompe, mais aussi des STICs On the other, oophorectomy increases the relative risk for cardiovascular, osteoporotic psychosexual and cognitive dysfunctions in premenopausal women. This raises the question whether bilateral salpingectomy could be an effective strategy in the prevention of ovarian cancer in case of hereditary predisposition and in the general population. "
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    ABSTRACT: A recent hypothesis has stated that many ovarian cancers (especially high-grade serous histotype) could arise from the distal part of the fallopian tube. On one hand we know that risk-reducing salpingo-oophorectomy is the most effective prevention for ovarian cancer among BRCA mutation carriers. On the other, oophorectomy increases the relative risk for cardiovascular, osteoporotic psychosexual and cognitive dysfunctions in premenopausal women. This raises the question whether bilateral salpingectomy could be an effective strategy in the prevention of ovarian cancer in case of hereditary predisposition and in the general population. Here we discuss origin of ovarian cancer in the light of the latest molecular studies and the relative risks and benefits of a strategy of exclusive salpingectomy in comparison with the classical adnexectomy. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
    Full-text · Article · Jan 2015 · La Presse Médicale
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    • "Les trompes de cancers ovariens séreux de haut grade sporadiques (sans mutation génétique BRCA et non associés à un syndrome de Lynch) ont alors été réexaminées à la recherche de lésions tubaires prénéoplasiques : une séquence identique a été mise en évidence mais, dans une proportion moins importante (30 à 50 % de lésions STICs) [17] [18] [19] [20] [21] [22]. Le fait que ces lésions tubaires précèdent le cancer invasif peut être affirmé par : présence de STICs sans cancer ovarien sur les annexectomies prophylactiques pour risque génétique [7] [8] [9] [10] [11] [12] ; profils moléculaires identiques entre STILs, STICs et cancers invasifs : mutations identiques du TP53 dans 93 % des cas [23], surexpression des gênes RSF-1, Cycline E, p16, FASN, stathmine (marqueur de la voie de signalisation PI3K), laminine g 1, suggérant une expansion clonale à partir des lésions tubaires [24] [25] ; présence de cellules souches électivement localisées au niveau de la partie distale de la trompe, mais aussi des STICs On the other, oophorectomy increases the relative risk for cardiovascular, osteoporotic psychosexual and cognitive dysfunctions in premenopausal women. This raises the question whether bilateral salpingectomy could be an effective strategy in the prevention of ovarian cancer in case of hereditary predisposition and in the general population. "

    Full-text · Article · Jan 2015
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    • "67 7 (10%) 4 (57%) Finch et al. [37] 159 7 (4%) 6 (86%) Callahan et al. [38] 100 7 (7%) 7 (100%) Leeper et al. [39] 30 5 (17%) 3 (60%) Medeiros et al. [40] 13 5 (38%) 5 (100%) Hirst et al. [41] "
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    ABSTRACT: Our understanding of the early natural history of epithelial ovarian carcinoma is limited by the access to early lesions as the disease is very often diagnosed at advanced stages. The incessant ovulation theory from the last century that indicated the ovary as the site for the initiation of high-grade serous cancers is contrary to the newly emerging idea that ovarian cancer could arise from the distal fallopian tube. In view of the recent pathological and molecular studies, we propose to discuss the genesis of high-grade serous ovarian cancer.
    Full-text · Article · Mar 2013 · Critical reviews in oncology/hematology
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