Serous Tubal Carcinogenesis: The Recent Concept of Origin of Ovarian, Primary Peritoneal and Fallopian Tube High-Grade Serous Carcinoma

Kar, Tushar; Kar, Asaranti; Dhal, Ipsita; Panda, Sasmita; Biswal, Priyadarshini; Nayak, Bhagyalaxmi; Rout, Niranjan; Samantray, S. K.

doi:10.1007/s13224-017-1009-0

Cited by 12 publications

(3 citation statements)

References 25 publications

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“…Study done by Kar et al had 58.21 % cystic tumors, 13.43 % solid and 28.36 % combined solid and cystic tumors. 9 Patients with solid or complex ovarian tumors are at high risk of ovarian malignancy was shown in study done by McDonald JM et al 12 Surface epithelial tumors constituted the most common category in the present study contributing to 84 % of all tumors followed by germ cell tumors, sex cord stromal tumors and metastatic tumors in decreasing order of frequency as seen in other studies done in neighboring countries like Pakistan and India.…”

Section: Discussionsupporting

confidence: 73%

Histopathological study of ovarian neoplasms in a tertiary healthcare center of Madesh Province

Alam,

Chaurasiya,

Akhtar

et al. 2023

J Pathol Nep

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Background: Ovarian tumors are a common form of neoplasm in women. Early diagnosis and management of ovarian tumors is a major problem in a developing country like Nepal, due to lack of awareness and limited facility for investigations in all parts of Nepal. Usually, the malignant ovarian neoplasms will have already advanced too far by the time they are detected. This study was proposed to identify the spectrum of ovarian tumors and their clinicopathological features. Materials and methods: This was a hospital-based cross-sectional descriptive study over a period of two years. Ovarian tissue with clinical notes sent to the histopathology department in 10% formalin was received. The specimens were subjected to critical gross as well as histopathological study. Routine paraffin sections with Hematoxylin & Eosin staining were used. The clinical as well as histological findings were compiled on proforma and then subjected to analysis. This was a descriptive study and data were tabulated and analyzed using the Statistical Package for Social Sciences (SPSS) version 21.0 Results: A total of 50 patients were included in the study with the age range from 15 years to 63 years. Maximum patients were from age group 41-50 years (36%). In the present study, abdominal pain (62%) was the most common presenting complaint followed by mass per abdomen (20%) and irregular periods (10%). The majority of the ovarian tumors belonged to benign tumors (82%) followed by malignant tumors (12%). As per WHO classification, surface epithelium tumors were found to be the most common variety (84%), followed by germ cell tumors (10%). Among the various known subtypes of ovarian tumors, serous cystadenoma (48%) was found to be the most common subtype followed by mucinous cystadenoma (20%). Conclusions: Benign ovarian tumors are more common than malignant or borderline tumors. Among the histopathological subtypes of ovarian tumors, surface epithelial tumors are the most common type. Differentiation between benign and malignant tumors is important to assure proper management and recovery. Similar studies with greater sample size are advisable in the future.

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Section: Discussionsupporting

confidence: 73%

Histopathological study of ovarian neoplasms in a tertiary healthcare center of Madesh Province

Alam,

Chaurasiya,

Akhtar

et al. 2023

J Pathol Nep

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“…Thus, ESPs – irrespective of size or level of atypia – deserve attention as possible additional sources, which in turn supports the tubal theory of serous carcinogenesis. Moreover, in a recent report in which STIC was found in 28% of HGSCs, ESPs were detected in an additional 46%, although no molecular studies were performed to determine if they were related to the co‐existing malignancies . (2) Some STICs have been classified as metastatic based on next‐generation sequencing, again requiring that more attention be made to these less conspicuous proliferations as potential sites of origin .We have observed examples of bilateral lesions sharing the same mutation, one a STIC and the other a STIL .…”

Section: Discussionmentioning

confidence: 93%

Evidence for lineage continuity between early serous proliferations (ESPs) in the Fallopian tube and disseminated high‐grade serous carcinomas

Soong

Howitt

Miron³

et al. 2018

The Journal of Pathology

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The distal Fallopian tube is a site of origin for many 'ovarian' high-grade serous carcinomas (HGSCs) with intraepithelial carcinomas (STICs) that share identical TP53 mutations with metastatic tumors. TP53 mutation-positive early serous proliferations (ESPs) comprise a spectrum including p53 signatures and serous tubal intraepithelial lesions (STILs) and are not considered malignant; however, ESPs are often the only abnormality found in Fallopian tubes of women with metastatic HGSC. The purpose of this study was to determine if a relationship exists between isolated ESPs and concurrent metastatic HGSCs in the absence of STIC. Fallopian tubes from 32 HGSCs without a co-existing STIC/HGSC in the endosalpinx were exhaustively sectioned. The presence of either STIC/HGSC or ESP in the endosalpinx was documented and DNA from tissues containing ESPs, concurrent HGSC, and control epithelia were interrogated for TP53 mutations by targeted amplicon-based sequencing with average coverage reads >4000 across DNA replicate samples. Serial sectioning revealed a previously unrecognized STIC/HGSC in 3 of 32 (9.3%) and ESPs in 13 (40.6%). Twelve contained TP53 mutations. Nine (75%) shared identical TP53 mutations with concurrent HGSCs, four at high (≥ 5%) and five at low (< 5%) allele frequency. All control epithelia were TP53 mutation-negative. This study, for the first time, indicates lineage identity between ESPs in the distal tube and some metastatic HGSCs via a shared site-specific TP53 mutation. It supports a novel serous carcinogenic sequence in which an ESP could eventually culminate in a metastatic serous cancer via 'precursor escape' and would explain the apparent sudden onset of cancers without co-existing STICs. This paradigm for serous cancer development underscores the likelihood that multiple precursor types in the Fallopian tube contribute to serous cancer development with implications for the evolution, pathologic classification, and prevention of this lethal malignancy. Copyright © 2018 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

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“…After the discovery of "serous carcinogenesis" of the fallopian tube mucosa and its role in the occurrence of serous ovarian and peritoneal cancers, the study of the causes, features of diagnosis, and treatment of FTC became even more relevant [14,15,16,17]. This discovery provided a practical opportunity to effectively prevent ovarian and peritoneal cancer by opportunistic salpingectomy in post-reproductive age.…”

Section: Causes Of Ftcmentioning

confidence: 99%

Primary Fallopian Tube Cancer: A Literature Review

Sumtsov

2023

EUMJ

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This literature review presents an analysis of diagnostic methods and treatment of a relatively rare and highly malignant tumor – primary fallopian tube cancer, which is poorly studied and difficult to diagnose. The study of the fallopian tube disorder is very relevant, as the fallopian tube mucosa can be a source of "serous carcinogenesis" for serous ovarian and peritoneal cancer. The author selected more than 50 scientific works from the world literature on the problems of incidence, diagnosis, and treatment of primary fallopian tube cancer and conducted a detailed analysis of them. The author draws attention to the risk group for primary fallopian tube cancer. Women with BRCA-1 and BRCA-2 mutations are more likely to develop FTC, especially in families with a history of breast and (or) ovarian cancer. Approximately 30% of women with FTC have a BRCA-1 or BRCA‑2 mutation. All patients with a burdened history and pathologic mutations should be considered candidates for routine rehabilitation. The author analyzes options for improving preoperative diagnosis using modern methods of additional examination, such as tumor markers, vacuum suction biopsy, transvaginal ultrasound, CT and MRI, and diagnostic laparoscopy. The author emphasizes that it is possible to avoid diagnostic errors during operations using a detailed examination of the affected fallopian tube mucosa on a longitudinal section and suboperative methods of morphological diagnosis. In addition, the author points out the prognostic importance of adequate staging and complete courses of adjuvant polychemotherapy according to modern clinical protocols. The author also draws attention to the interdependence of prevention methods, diagnosis, and treatment of FTC and ovarian cancer.

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Serous Tubal Carcinogenesis: The Recent Concept of Origin of Ovarian, Primary Peritoneal and Fallopian Tube High-Grade Serous Carcinoma

Abstract: This revelation concludes that fallopian tubes are the sites of precursors of PHGSC to a large extent. In the absence of a proper screening method of HGSC, prophylactic bilateral salpingectomy at hysterectomy for benign diseases can achieve ultimate goal of reduction in incidence of PHGSC.

Cited by 12 publications

References 25 publications

Histopathological study of ovarian neoplasms in a tertiary healthcare center of Madesh Province

Histopathological study of ovarian neoplasms in a tertiary healthcare center of Madesh Province

Evidence for lineage continuity between early serous proliferations (ESPs) in the Fallopian tube and disseminated high‐grade serous carcinomas

Primary Fallopian Tube Cancer: A Literature Review

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