High grade mucosal serous carcinoma of fallopian tube and serous tubal intraepithelial carcinoma (STIC) coexistent with ectopic tubal gestation

Abstract

High-grade serous tubal intraepithelial carcinomas (STICs) are noninvasive carcinomas of the fallopian tube that have been found with varying frequency in tubectomy specimens. Serous tubal intraepithelial carcinoma is a precursor lesion for high-grade serous ovarian and peritoneal carcinoma. The incidence of STIC is estimated to occur in 0.6% to 6% of women who are BRCA positive or have a strong family history of breast or ovarian carcinoma. Immunohistochemical staining demonstrates aberrant p53 protein [removed]either diffuse nuclear over expression or complete absence of staining) and an increased Ki-67 proliferation index. We are describing rare incidental occurrence of high grade mucosal serous carcinoma of the fallopian tube with STIC in a patient undergoing tubectomy for ectopic tubal gestation and relevant immunohistochemical study of the lesion. Much attention has been directed to the fallopian tubes as the origin of malignant epithelial ovarian tumors, and STIC is now considered to be the origin of high-grade serous ovarian cancer. To avoid overlooking early-stage fallopian tube cancer, surgery for benign disease should also be accompanied by a detailed histopathological examination of the fallopian tubes. Possible management options include observation with annual physical examination and CA-125 estimation, surgical staging, or empiric chemotherapy. However, due to the lack of consensus regarding management options, referral to a gynecologic oncologist recommended. Associated ectopic gestation is probably due to partial obstruction caused by mucosal serous carcinoma of fallopian tube. Close spatial relationship of two such lesions suggests that, in all probability intraluminal mucosal carcinoma was responsible for interference in free transportation of the fertilized ovum through the tube , possibly, by impaired contractile activity of myosalpinx and consequently caused the ectopic tubal pregnancy. Keywords: Serous tubal intraepithelial c