Serous tubal intraepithelial carcinoma (STIC) is now considered a putative precursor lesion of most extrauterine high-grade serous carcinomas (HGSC). It is frequently reported in high-risk women and women with advanced-stage serous carcinoma. This case study reports a serous high-grade carcinoma (HGSC) consisting of a bilateral STIC with a focus of stromal invasion in the left tube, and a peritoneal HGSC. The grossly normal-appearing tubes including the fimbriated ends were sectioned following the SEE-FIM protocol. In both tubes, tumor aggregates were exfoliated extensively to the tubal lumens. The neoplastic epithelia in any location were diffusely positive for p53 in strong nuclear patterns. Pelvic lymph nodes were negative for tumor on serial sections and keratin 7 immunohistochemistry, and there was no evidence of lymphatic vessel involvement. The lack of any evidence of lymphovascular invasion and regional lymph node metastases supports the interpretation of intraluminal and transcoelomic spread, and may be taken as evidence of dissemination of tubal neoplastic cells by exfoliation in this case. The biology of transcoelomic spread is reviewed in this manuscript.
High-grade serous carcinoma, serous tubal intraepithelial carcinoma, STIC, intraluminal exfoliation, peritoneum, transcoelomic spread, pelvic lymph nodes
The authors report no conflict of interest.
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Brustmann H. Bilateral serous tubal intraepithelial carcinoma associated with high-grade serous carcinoma of the peritoneum: evidence for transcoelomic tumor spread by extended lymph node evaluation. Proc Obstet Gynecol. 2019 Aug 29;9(1):Article 6 [10 p.]. https://doi.org/10.17077/2154-4751.1413. Free full text article.