Early adenocarcinoma of the fallopian tubes. A case for multifocal tumorigenesis.

Seven cases of carcinoma in situ and/or early invasive carcinoma of the fallopian tube found in association with serous carcinoma of the ovary are described. These cases are considered to represent examples of multicentric tumorigenesis in Müllerian epithelia which have a common origin and have responded to a common carcinogenic influence. Early neoplastic lesions of the tube may be overlooked unless the tube is serially blocked. If this is done, such lesions may be expected in 5-10% of patients with serous carcinoma of the ovary. Criteria for diagnosis of carcinoma in situ are discussed, viz., a noninvasive proliferative epithelial lesion with disorganization of cellular relationships, significant mitotic activity and nuclear atypia (especially prominence of nucleoli). Criteria for diagnosis of invasive carcinoma of fallopian tube are also referred to particularly with respect to establishing a primary site of tumor origin in cases where masses are present in both ovaries and tubes.