Mucosal Carcinoma of the Fallopian Tube Coexists only with the Serous Subtype of Ovarian Cancer: The First SEE-FIM Study in Asia
D Maeda, Y Takazawa, S Ota, K Ohashi, M Mori, T Imamura, M Fukayama. Graduate School of Medicine, the University of Tokyo, Tokyo, Japan; Toranomon Hospital, Tokyo, Japan; Mitsui Memorial Hospital, Tokyo, Japan; Teikyo University Hospital, Tokyo, Japan
Background: Previous studies in Western countries have revealed that mucosal carcinoma of the fallopian tube frequently coexists with pelvic (ovarian, tubal and peritoneal) high-grade serous carcinomas, and it is now regarded as a possible precursor of these lesions. The present study was performed to elucidate the relationship between mucosal carcinoma of the fallopian tube and ovarian cancers of various histological subtypes in the Japanese population.
Design: We prospectively submitted the fallopian tubes in toto for histological examination (SEE-FIM protocol) in 53 cases of ovarian carcinoma (serous, n=12; clear cell, n=23; endometrioid, n=9; mucinous, n=14; and others, n=5) and 3 cases of peritoneal serous carcinoma. The diagnosis of mucosal carcinoma of the fallopian tube was based solely on morphology. In serous adenocarcinoma cases, immunohistochemical analyses using antibodies to p53, WT-1, and Ki-67 were performed in the main ovarian/peritoneal tumors and coexisting tubal carcinomas when present.
Results: Mucosal carcinoma of the fallopian tube did not coexist with any of the non-serous adenocarcinomas (n=41). By contrast, tubal mucosal carcinoma was observed in 7 of the 15 serous adenocarcinomas. Of these seven cases, six had coexisting tubal carcinoma in the fimbria only, while in the remaining case, mucosal carcinoma was observed in both the fimbriated and non-fimbriated tubal mucosa. In all cases, the immunophenotypes for p53 and WT-1 were similar in the tubal mucosal carcinoma and invasive ovarian or peritoneal carcinoma. The tumors were negative for p53 in 4 out of 7 cases, and one of the p53-negative serous adenocarcinomas had a low-grade morphology.
Conclusions: Mucosal carcinoma of the fallopian tube frequently coexists with pelvic serous adenocarcinomas in the Japanese population. Our results suggest that mucosal carcinoma of the fallopian tube may be a precursor of some pelvic serous carcinomas. However, alterations in p53 may not necessarily play a role in its development. Tubal lesions appear to be unrelated to the carcinogenesis of non-serous ovarian cancers, such as clear cell adenocarcinomas.
Category: Gynecologic & Obstetrics
Tuesday, March 23, 2010 1:00 PM
Poster Session IV # 143, Tuesday Afternoon