Article Text
Abstract
Introduction/Background The estimated frequency of serous tubal intraepithelial carcinoma(STIC) after risk reduction salpingo-oophorectomy (RROO) is 2%.
A patient of 41 years old, BRCA1 mutated, came to our institution for follow-up after receiving a RRSO, the pathology report detected a STIC in one of the tubes; 28 months after, an inguinal adenopathy is palpated, the biopsy was positive for high grade serous carcinoma(HGSC).
Methodology As there is controversy after the diagnose of a STIC we decide to:
analyze our STIC cases between January 2010 to September 2023.
perform a systematic review of the literature from 1/2010 to 9/2023, especially considering if any other medical or surgical treatment was added.
Patients diagnosed with STIC and coincident ovarian/tubal cancer were excluded.
Results We detected 6 patients with STIC diagnose in our hospital (Table 1).
4/6(66,67%) were BRCA mutated.
Follow-up was 5–131 months, only one patient develop HGSC, she presented negative CA 125, 22 U/mL, PET-CT showed hypermetabolic inguinal adenopathy, SUVmax 5,73. Inguinal lymphadenectomy was performed, Carbo-taxol 6 cycles and olaparib were prescribed.
One patient had positive peritoneal washing, after PET-CT and laparoscopy a pancreatic carcinoma was detected.
One surgical staging was performed, negative.
None receive chemotherapy.
After revision we found 126 STIC diagnoses the estimated subsequent high-grade serous carcinoma(HGSC) is 4,5–27,5% following different studies.
There is great heterogeneity in the management and follow-up, pelvic washings are frequent, surgical staging or chemotherapy were indicated according to local decisions.
SEE FIM protocol is performed in the majority of centers.
No patient who received surgical staging or chemotherapy develop peritoneal carcinomatosis.
Conclusion Patients diagnosed with STIC can develop HGSC, follow-up is recommended, specially if BRCA mutated.
After diagnose of STIC surgical staging should be considered, observation is an option, there is insufficient data to recommend chemotherapy.
Prospective trials are needed.
Disclosures 0