Sabelli Renata, Tessier-Cloutier Basile, Fu Lili, Leung Shuk On Annie, Zeng Xing, Ribeiro Reitan, Mandilaras Victoria, Gilbert Lucy, Bernard Laurence
Faculty of Medicine and Health Sciences, McGill University, Canada.
Department of Pathology, McGill University, Canada.
Gynecol Oncol Rep. 2025 Mar 5;58:101716. doi: 10.1016/j.gore.2025.101716. eCollection 2025 Apr.
High-grade serous carcinoma (HGSC) arise from serous tubal intraepithelial carcinoma (STIC) lesions, a precursor that develops from the fallopian tube epithelium. Patients with incidental isolated STIC lesions found on salpingectomy specimen have up to 25% risk of developing HGSC or peritoneal carcinomatosis in the future, yet there is no established consensus to guide management.
This retrospective case series includes patients diagnosed with isolated STIC lesions between April 2017 and January 2024. Patient data was extracted from clinical and pathological databases.
During the study period, 10 patients were diagnosed with an isolated STIC lesion. The fallopian tubes were removed either as part of a hysterectomy for endometrial cancer (n = 3); a prophylactic risk-reducing surgery for or mutation (n = 3); or a benign gynecologic condition (n = 4). The median age of the patients was 64 years (range: 53-80). Among patients who underwent genetic testing (n = 9), only three were found to have a deleterious germline mutation in or . The patients either received adjuvant chemotherapy (n = 5) or underwent active surveillance (n = 5). One surveillance patient was managed with completion bilateral oophorectomy and omentectomy. Median number of chemotherapy cycles was four (range 4-6 cycles). The median follow-up was 27 months (range: 5-83 months). One patient under active surveillance was diagnosed with peritoneal carcinomatosis 5 years after initial diagnosis of STIC whereas none recurred in the chemotherapy group.
The wide variety of treatment approaches we observed highlights a need for more data on this entity to support management guidelines.
高级别浆液性癌（HGSC）起源于浆液性输卵管上皮内癌（STIC）病变，这是一种由输卵管上皮发展而来的前驱病变。在输卵管切除标本中偶然发现孤立性STIC病变的患者，未来发生HGSC或腹膜癌的风险高达25%，但目前尚无既定的共识来指导治疗。
本回顾性病例系列包括2017年4月至2024年1月期间被诊断为孤立性STIC病变的患者。患者数据从临床和病理数据库中提取。
在研究期间，10例患者被诊断为孤立性STIC病变。输卵管切除是作为子宫内膜癌子宫切除术的一部分（n = 3）；因 或 突变进行的预防性降低风险手术（n = 3）；或良性妇科疾病（n = 4）。患者的中位年龄为64岁（范围：53 - 80岁）。在接受基因检测的患者（n = 9）中，只有3例在 或 中发现有害的种系突变。患者要么接受辅助化疗（n = 5），要么接受主动监测（n = 5）。一名接受监测的患者接受了双侧卵巢切除术和网膜切除术。化疗周期的中位数为4个（范围4 - 6个周期）。中位随访时间为27个月（范围：5 - 83个月）。一名接受主动监测的患者在初次诊断STIC后5年被诊断为腹膜癌，而化疗组无复发。
我们观察到的广泛多样的治疗方法凸显了需要更多关于该实体的数据来支持治疗指南。
