Characteristic Features of Serous Tubal Intraepithelial Carcinoma and Its Co-Existing Invasive Carcinomas
Faye F Gao, Rohit Bhargava, Huaitao Yang, Zaibo Li, Chengquan Zhao. University of Pittsburgh Medical Center, Pittsburgh, PA; Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA
Background: In the past several decades, the concept of serous ovarian carcinoma has been progressively revised. However, the exact pathogenesis remains controversial. The most recent concept for pelvic high grade serous carcinoma (HGSC) origin is the fimbriated end of fallopian tube. The objective of our study was to evaluate the characteristic features of serous tubal intraepithelial carcinoma (STIC).
Design: 97 cases with STIC were retrieved from our pathology database by using the keyword “serous tubal intraepithelial carcinoma”. The pathology reports and selected slides were reviewed. Detailed clinical and pathological information was collected for analysis. The Standard SEE-FIM protocol was applied firmly in our institution since 2008. Tumors were classified as ovarian, peritoneal, tubal or endometrial primary based on conventional criteria.
Results: Of the 97 STIC cases (2007 to June 2011), 89 cases showed coexisting pelvic HGSCs. The remaining 8 included 3 STIC only cases, one STIC case coexisting with EIC, two cases with endometrioid endometrial adenocarcinoma, one with invasive cervical squamous cell carcinoma, and one with ovarian low grade serous carcinoma. Of the 89 STIC cases associated with HGSC, 51 (57%) were attributed to be of FT origin, 26 (29%) to be of ovarian origin, 9 (10%) of peritoneal origin, and 3 (4%) of endometrial origin based on the presence of the bulk of the tumor. Most of these tumors were widely disseminated at presentation with omental/peritoneal involvement seen in 92% cases, and lymph node and lymphovascular involvement in 49% and 48% cases, respectively. The age, race, and FIGO stage showed no significant difference among the four groups of HGSC.
Conclusions: To our knowledge, this is the largest study evaluating distribution of carcinomas associated with STIC. Although STIC is considered a precursor for most ovarian and primary peritoneal HGSC, the primary tubal cancers are still far more common in presence of a STIC compared with ovarian HGSC. Most ovarian HGSC might originate from the epithelium of the fallopian tube, but substantial percentage of the cases may not be related to STIC. The high percentage of omental involvement (92%) in these tumors suggests direct extension of the tumor cells due to associated STIC.
Category: Gynecologic & Obstetrics
Tuesday, March 20, 2012 1:00 PM
Poster Session IV # 140, Tuesday Afternoon