Yoshida H, Shintani D, Imai Y, Fujiwara K
Eur J Gynaecol Oncol. 2016;37(3):404-6.
Serous tubal intraepithelial carcinoma (STIC) is considered the precursor of pelvic serous carcinomas and the earliest malignant alteration in BRCA mutation-positive women. Recently, risk-reducing salpingo-oophorectomy (RRSO) is being performed in BRCA mutation-positive women and STIC is often discovered incidentally in the fallopian tubes. A 62-year-old woman underwent bilateral salpingo-oophorectomy (BSO) for ovarian cysts. Ten months later, cytological screening for the endometrium revealed adenocarcinoma. No atypical tissue was detected by the endometrial curettage. Imaging tests and hysteroscopy found no abnormal findings. She underwent hysterectomy and was diagnosed with STIC originating from the intrauterine portion of the residual fallopian tube. Here, the authors report the first case of STIC being detected during an endometrial cytological examination after BSO. Although STIC associated with the BRCA mutation usually involves the distal fallopian tube, the present case suggests that the intrauterine portion of the fallopian tube should be removed or cauterized during RRSO.
浆液性输卵管上皮内癌(STIC)被认为是盆腔浆液性癌的前驱病变,也是BRCA突变阳性女性最早出现的恶性改变。近来,BRCA突变阳性女性会接受降低风险的输卵管卵巢切除术(RRSO),STIC常在输卵管中被偶然发现。一名62岁女性因卵巢囊肿接受了双侧输卵管卵巢切除术(BSO)。十个月后,子宫内膜细胞学筛查显示为腺癌。子宫内膜刮宫未检测到非典型组织。影像学检查和宫腔镜检查未发现异常。她接受了子宫切除术,被诊断为源自残留输卵管子宫内部的STIC。在此,作者报告了首例在BSO后子宫内膜细胞学检查期间检测到STIC的病例。尽管与BRCA突变相关的STIC通常累及输卵管远端,但本病例提示在RRSO期间应切除或烧灼输卵管的子宫内部部分。