We experienced a case of serous tubal intraepithelial carcinoma (STIC), which is the earliest morphologically recognizable precursor of pelvic high grade serous carcinoma, diagnosed by cytology during the operation. A 48-year-old Japanese woman visited to our department because of abnormal cytological result and the left adnexal mass on female cancer screening. Pre-operatively, she was diagnosed as cervical intraepithelial neoplasia (CIN) 3, adenomyosis, and the left adnexal cystic lesion with papillary growth. At laparotomy, the left adnexal tumor turned out to be cystic fallopian tube with small papillary growth on the inner surface, but abnormal findings were not present on bilateral ovaries. The cytology of the imprint smears from the papillary projection and ascitic fluid showed positive, suggesting serous adenocarcinoma. Histopathological examination of the lesion revealed the left fallopian tube lesion was STIC with immunohistochemically positive reactivity against p53. No metastases including disseminated lesions were noted. The patient received four courses of systemic chemotherapy, and had no recurrent signs 10 months after the operation.
References
[1]
Liao, C.I., Chow, S., Chen, L.M., Kapp, D.S., Mann, A., and Chan, J.K. (2018) Trends in the Incidence of Serous Fallopian Tube, Ovarian, and Peritoneal Cancer in the US. Gynecologic Oncology, 149, 318-323.
https://doi.org/10.1016/j.ygyno.2018.01.030
[2]
Piek, J.M., van Diest, P.J., Zweemer, R.P., Jansen, J.W., Poort-Keesom, R.J., Menko, F.H., Gille, J.J., Jongsma, A.P., Pals, G., Kenemans, P. and Verheijen, R.H. (2001) Dysplastic Changes in Prophylactically Removed Fallopian Tubes of Women Predisposed to Developing Ovarian Cancer. The Journal of Pathology, 195, 451-456.
https://doi.org/10.1002/path.1000
[3]
Kindelberger, D.W., Lee, Y., Miron, A., Hirsch, M.S., Feltmate, C., Medeiros, F., Callahan, M.J., Garner, E.O., Gordon, R.W., Birch, C., Berkowitz, R.S., Muto, M.G. and Crum, C.P. (2007) Intraepithelial Carcinoma of the Fimbria and Pelvic Serous Carcinoma: Evidence for a Causal Relationship. The American Journal of Surgical Pathology, 31, 161-169. https://doi.org/10.1097/01.pas.0000213335.40358.47
[4]
Ottevanger, P.B. (2017) Ovarian Cancer Stem Cells More Questions than Answers. Seminars in Cancer Biology, 44, 67-71.
https://doi.org/10.1016/j.semcancer.2017.04.009
[5]
Crum, C.P., Herfs, M., Ning, G., Bijron, J.G., Howitt, B.E., Jimenez, C.A., Hanamornroongruang, S., McKeon, F.D. and Xian, W. (2013) Through the Glass Darkly: Intraepithelial Neoplasia, Top-Down Differentiation, and the Road to Ovarian Cancer. The Journal of Pathology, 231, 402-412. https://doi.org/10.1002/path.4263
[6]
Jarboe, E., Folkins, A., Nucci, M.R., Kindelberger, D., Drapkin, R., Miron, A., Lee, Y. and Crum, C.P. (2008) Serous Carcinogenesis in the Fallopian Tube: A Descriptive Classification. International Journal of Gynecological Pathology, 27, 1-9.
https://doi.org/10.1097/pgp.0b013e31814b191f
[7]
Kurman, R.J. and Shih Ie, M. (2010) The Origin and Pathogenesis of Epithelial Ovarian Cancer: A Proposed Unifying Theory. The American Journal of Surgical Pathology, 34, 433-443. https://doi.org/10.1097/PAS.0b013e3181cf3d79
[8]
Visvanathan, K., Vang, R., Shaw, P., Gross, A., Soslow, R., Parkash, V., Shih Ie, M. and Kurman, R.J. (2011) Diagnosis of Serous Tubal Intraepithelial Carcinoma Based on Morphologic and Immunohistochemical Features: A Reproducibility Study. The American Journal of Surgical Pathology, 35, 1766-1775.
https://doi.org/10.1097/PAS.0b013e31822f58bc
[9]
Meyer, L.A., Anderson, M.E., Lacour, R.A., Suri, A., Daniels, M.S., Urbauer, D.L., Nogueras-Gonzalez, G.M., Schmeler, K.M., Gershenson, D.M. and Lu, K.H. (2010) Evaluating Women with Ovarian Cancer for BRCA1 and BRCA2 Mutations: Missed Opportunities. Gynecologic Oncology, 115, 945-952.
https://doi.org/10.1097/AOG.0b013e3181da08d7
[10]
Palma, M., Ristori, E., Ricevuto, E., Giannini, G. and Gulino, A. (2006) BRCA1 and BRCA2: The Genetic Testing and the Current Management Options for Mutation Carriers. Critical Reviews in Oncology/Hematology, 57, 1-23.
https://doi.org/10.1016/j.critrevonc.2005.05.003
[11]
Patrono, M.G., Iniesta, M.D., Malpica, A., Lu, K.H., Fernandez, R.O., Salvo, G. and Ramirez, P.T. (2015) Clinical Outcomes in Patients with Isolated Serous Tubal Intraepithelial Carcinoma (STIC): A Comprehensive Review. Gynecologic Oncology, 139, 568-572. https://doi.org/10.1016/j.ygyno.2015.09.018
[12]
Zakhour, M., Danovitch, Y., Lester, J., Rimel, B.J., Walsh, C.S., Li, A.J., Karlan, B.Y. and Cass, I. (2016) Occult and Subsequent Cancer Incidence Following Risk-Reducing Surgery in BRCA Mutation Carriers. Gynecologic Oncology, 143, 231-235. https://doi.org/10.1016/j.ygyno.2016.08.336
[13]
Chen, H., Klein, R., Arnold, S., Chambers, S. and Zheng, W. (2016) Cytologic Studies of the Fallopian Tube in Patients Undergoing Salpingo-Oophorectomy. Cancer Cell International, 16, 78. https://doi.org/10.1186/s12935-016-0354-x
[14]
Mehra, K., Mehrad, M., Ning, G., Drapkin, R., McKeon, F.D., Xian, W. and Crum, C.P. (2011) STICS, SCOUTs and p53 Signatures; A New Language for Pelvic Serous Carcinogenesis. Frontiers in Bioscience (Elite Edition), 3, 625-634.
[15]
Malmberg, K., Klynning, C., Floter-Radestad, A. and Carlson, J.W. (2016) Serous Tubal Intraepithelial Carcinoma, Chronic Fallopian Tube Injury, and Serous Carcinoma Development. Virchows Arch, 468, 707-713.
https://doi.org/10.1007/s00428-016-1928-7
[16]
Salvador, S., Gilks, B., Kobel, M., Huntsman, D., Rosen, B. and Miller, D. (2009) The Fallopian Tube: Primary Site of Most Pelvic High-Grade Serous Carcinomas. International Journal of Gynecological Cancer, 19, 58-64.
https://doi.org/10.1111/IGC.0b013e318199009c
[17]
Takeshita, R., Shoji, T., Mukaida, R., Sato, T., Sasou, S., Itamochi, H. and Sugiyama, T. (2017) A Case of High-Grade Serous Tubal Intraepithelial Carcinoma Diagnosed with Adenocarcinoma by Ascitic Fluid Cytology. Journal of Tumor, 5, 488-491.
[18]
Bamias, A., Papadimitriou, C., Efstathiou, E., Rodolakis, A., Vlahos, G., Voulgaris, Z., Bozas, G., Fountzilas, G., Aravantinos, G., Razis, E., Gika, D. and Dimopoulos, M.A. (2006) Four Cycles of Paclitaxel and Carboplatin as Adjuvant Treatment in Early-Stage Ovarian Cancer: A Six-Year Experience of the Hellenic Cooperative Oncology Group. BMC Cancer, 6, 228.
[19]
Weinberger, V., Bednarikova, M., Cibula, D. and Zikan, M. (2016) Serous Tubal Intraepithelial Carcinoma (STIC)—Clinical Impact and Management. Expert Review of Anticancer Therapy, 16, 1311-1321.
https://doi.org/10.1080/14737140.2016.1247699
[20]
Tone, A.A., Virtanen, C., Shaw, P. and Brown, T.J. (2012) Prolonged Postovulatory Proinflammatory Signaling in the Fallopian Tube Epithelium May Be Mediated through a BRCA1/DAB2 Axis. Clinical Cancer Research, 18, 4334-4344.
https://doi.org/10.1158/1078-0432.CCR-12-0199
[21]
Crum, C.P., Parkash, V., Alvarado-Cabrero, I., Piek, J.M.J., Bijron, J.G., Shaw, P., Carcangiu, M.L., Soslow, R., Ferry, J.A., van Diest, P.J. and Vang, R. (2014) Epithelial Tumours and Cysts. In: Kurman, R.J., Carcangiu, M.L., Herrington, C.S. and Young, R.H., Eds., WHO Classification of Tumours of Female Reproductive Organs, International Agency for Research on Cancer (IARC), Lyon, 103-112.
[22]
Sasagawa, M., Nishino, K., Honma, S., Kodama, S. and Takahashi, T. (2003) Origin of Adenocarcinoma Cells Observed on Cervical Cytology. Acta Cytologica, 47, 410-414. https://doi.org/10.1159/000326542
[23]
Hong, M.K., Lee, M.H., Ding, D.C., Chu, S.C. and Chu, T.Y. (2015) High Grade Serous Ovarian Carcinoma with Serous Tubal Intraepithelial Carcinoma in a Case Presented with Atypical Glandular Cell Favor Neoplasm Cervical Cytology and Dermatomyositis. Taiwanese Journal of Obstetrics & Gynecology, 54, 183-186.
https://doi.org/10.1016/j.tjog.2013.07.004
[24]
Punnonen, R., Lauslahti, K. and Pystynen, P. (1985) Primary Malignancies of the Fallopian Tube. Annales Chirurgiae et Gynaecologiae. Supplementum, 197, 15-18.
[25]
Maeda, D., Takazawa, Y., Ota, S., Takeuchi, Y., Seta, A., Nakagawa, S., Yano, T., Taketani, Y. and Fukayama, M. (2010) Bilateral Microscopic Adenocarcinoma of the Fallopian Tubes Detected by an Endometrial Cytologic Smear. International Journal of Gynecological Pathology, 29, 273-277.
https://doi.org/10.1097/PGP.0b013e3181c30301
[26]
Manchanda, R., Drapkin, R., Jacobs, I. and Menon, U. (2012) The Role of Peritoneal Cytology at Risk-Reducing Salpingo-Oophorectomy (RRSO) in Women at Increased Risk of Familial Ovarian/Tubal Cancer. Gynecologic Oncology, 124, 185-191. https://doi.org/10.1016/j.ygyno.2011.10.017
[27]
Takahashi, M., Kigawa, J., Ishihara, K., Shimada, M., Kamei, T. and Terakawa, N. (2002) Hydrotubation for Diagnosing Carcinoma in Situ of the Fallopian Tube. A Case Report. Acta Cytologica, 46, 735-737. https://doi.org/10.1159/000326986
