Journal of Medicine and Life Science

Institute for Medical Science (제주대학교 의과학연구소)
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Serous tubal intraepithelial carcinoma detected during benign gynecologic surgery: a case report

  • Eun Seo Shin (Department of Obstetrics and Gynecology, Jeju National University Hospital) ;
  • Sung Yob Kim (Department of Obstetrics and Gynecology, Jeju National University College of Medicine)
  • Received : 2022.12.16
  • Accepted : 2023.02.06
  • Published : 2023.03.31
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Abstract

High-grade serous carcinoma (HGSC) is the most common type of pelvic cancer among women. Serous tubal intraepithelial carcinoma (STIC) is a precursor lesion of HGSC. Herein, we report a rare occurrence of STIC in patients undergoing surgery for benign indications without a family history of ovarian cancer. A 77-year-old woman underwent total laparoscopic hysterectomy and bilateral salpingo-oophorectomy for uterine prolapse. Pathological examination revealed bilateral STIC without ovarian abnormalities, and no other abnormal findings were noted. Another patient, a 49-year-old woman, underwent laparoscopic total hysterectomy and bilateral salpingectomy for uterine fibroids. STIC lesions were observed in both fallopian tubes. Subsequently, a staging was performed. No additional lesions were found, and the patient was followedup through imaging and blood tests. As reports of STIC lesions are rare, data on their clinical outcomes and management strategies are limited. In this report, we present cases of incidental STIC in benign surgery and discuss its proper interpretation and management. Through the early detection of STIC lesions, patients with risk factors can be identified in advance, which will allow prevention and early detection of ovarian cancer. Opportunistic salpingectomy was also actively discussed in this regard.

Keywords

Acknowledgement

This work was supported by the education, research and student guidance grant funded by Jeju National University.

References

  1. Bogaerts JMA, Steenbeek MP, van Bommel MHD, Bulten J, van der Laak JAWM, de Hullu JA, et al. Recommendations for diagnosing STIC: a systematic review and meta-analysis. Virchows Arch 2022;480:725-37. https://doi.org/10.1007/s00428-021-03244-w
  2. Walker JL, Powell CB, Chen LM, Carter J, Bae Jump VL, Parker LP, et al. Society of gynecologic oncology recommendations for the prevention of ovarian cancer. Cancer 2015;121:2108-20. https://doi.org/10.1002/cncr.29321
  3. Committee on Gynecologic Practice. ACOG committee opinion No. 774: opportunistic salpingectomy as a strategy for epithelial ovarian cancer prevention. Obstet Gynecol 2019;133:e279-84. https://doi.org/10.1097/AOG.0000000000003164
  4. Bachert SE, McDowell A Jr, Piecoro D, Baldwin Branch L. Serous tubal intraepithelial carcinoma: a concise review for the practicing pathologist and clinician. Diagnostics (Basel) 2020;10:102.
  5. Vaughan MH, Modesitt SC, Mo Y, Trowbridge ER. Serous tubal intraepithelial carcinoma: an incidental finding at the time of prophylactic bilateral salpingo-oophorectomy. Case Rep Obstet Gynecol 2015;2015:760429.
  6. Meserve EEK, Mirkovic J, Conner JR, Yang E, Muto MG, Horowitz N, et al. Frequency of "incidental" serous tubal intraepithelial carcinoma (STIC) in women without a history of or genetic risk factor for high-grade serous carcinoma: a six-year study. Gynecol Oncol 2017;146:69-73. https://doi.org/10.1016/j.ygyno.2017.04.015
  7. Yamamoto T, Shimura K, Sugahara T, Ogiso N, Okubo T. Incidental serous tubal intraepithelial carcinoma detected by a surgery for ectopic pregnancy. Open J Obstet Gynecol 2020;10:738-43. https://doi.org/10.4236/ojog.2020.1050068
  8. Wethington SL, Park KJ, Soslow RA, Kauff ND, Brown CL, Dao F, et al. Clinical outcome of isolated serous tubal intraepithelial carcinomas (STIC). Int J Gynecol Cancer 2013;23:1603-11. https://doi.org/10.1097/IGC.0b013e3182a80ac8
  9. Patrono MG, Corzo C, Iniesta M, Ramirez PT. Management of preinvasive lesions. Clin Obstet Gynecol 2017;60:771-9. https://doi.org/10.1097/GRF.0000000000000316
  10. Van der Hoeven NMA, Van Wijk K, Bonfrer SE, Beltman JJ, Louwe LA, De Kroon CD, et al. Outcome and prognostic impact of surgical staging in serous tubal intraepithelial carcinoma: a cohort study and systematic review. Clin Oncol (R Coll Radiol) 2018;30:463-71. https://doi.org/10.1016/j.clon.2018.03.036