This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Carlson, J. W. Articles by Crum, C. P. Search for Related Content PubMed PubMed Citation Articles by Carlson, J. W. Articles by Crum, C. P. Social Bookmarking                            What's this?

Serous Tubal Intraepithelial Carcinoma: Its Potential Role in Primary Peritoneal Serous Carcinoma and Serous Cancer Prevention

Joseph W. Carlson, Alexander Miron, Elke A. Jarboe, Mana M. Parast, Michelle S. Hirsch, Yonghee Lee, Michael G. Muto, David Kindelberger, Christopher P. Crum

From the Division of Women's and Perinatal Pathology, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School; and Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA

Corresponding author: Christopher P. Crum, MD, Department of Pathology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115; e-mail: ccrum{at}partners.org

Purpose A diagnosis of primary peritoneal serous carcinoma (PPSC) requires exclusion of a source in other reproductive organs. Serous tubal intraepithelial carcinoma (STIC; stage 0) has been described in asymptomatic women with BRCA mutations and linked to a serous cancer precursor in the fimbria. This study examined the frequency of STIC in PPSC and its clinical outcome in BRCA-positive women.

Patients and Methods Presence or absence of STIC was recorded in consecutive cases meeting the 2001 WHO criteria for PPSC, including 26 patients with nonuniform sampling of the fallopian tubes (group 1) and 19 patients with complete tubal examination (group 2; sectioning and extensively examining the fimbriated end, or SEE-FIM protocol). In selected cases, STIC or its putative precursor and the peritoneal tumor were analyzed for p53 mutations (exons 1 to 11). Outcome of STIC was ascertained by literature review.

Result Thirteen (50%) of 26 PPSCs in group 1 involved the endosalpinx, with nine STICs (35%). Fifteen (79%) of 19 cases in group 2 contained endosalpingeal involvement, with nine STICs (47%). STIC was typically fimbrial and unifocal, with variable invasion of the tubal wall. In five of five cases, the peritoneal and tubal lesion shared an identical p53 mutation. Of 10 reported STICs in BRCA-positive women, all patients were without disease on follow-up.

Conclusion The fimbria is the source of nearly one half of PPSCs, suggesting serous malignancy originates in the tubal mucosa but grows preferentially at a remote peritoneal site. The generally low risk of recurrence in stage 0 (STIC) disease further underscores STIC as a possible target for early serous cancer detection and prevention.

Supported by grants from the National Cancer Institute (Grants No. P50 CA10500 [SPORE]: D. Cramer, principal investigator; NCI KO8 CA108748, R. Drapkin, principal investigator; NCI 1R21CA124688-01A1, C.P.C., principal investigator), the Charlotte Geyer Foundation (C.P.C., principal investigator), the Columbia Hospital for Women Research Foundation (C.P.C., principal investigator), the Dana-Farber Cancer Institute, and the Francis Ward Paine and TSA Pemberton Funds from the Division of Women's and Perinatal Pathology, Brigham and Women's Hospital.

J.W.C. and A.M. contributed equally to this work.

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				M. H. Greene and P. L. Mai What Have We Learned from Risk-Reducing Salpingo-oophorectomy? J Natl Cancer Inst, January 21, 2009; 101(2): 70 - 71. [Full Text] [PDF]

				K. Levanon, C. Crum, and R. Drapkin New Insights Into the Pathogenesis of Serous Ovarian Cancer and Its Clinical Impact J. Clin. Oncol., November 10, 2008; 26(32): 5284 - 5293. [Abstract] [Full Text] [PDF]