Occult tubal carcinoma found at risk reducing salpingectomy in a BRCA1 carrier

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Highlights

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This is the first report of occult cancer diagnosed at risk-reducing salpingectomy.

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We propose a two-step risk-reducing strategy for premenopausal high-risk women, to begin and expedite surgical prevention.

Article outline

• Highlights
• Keyword
• Introduction
• Case
• Discussion
• Conflict of interest statement
• References

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Introduction

Recent studies highlight the importance of the fallopian tube as a putative site of origin for serous ovarian carcinomas, previously felt to arise exclusively from ovarian tissue. The initial association emerged from the pathologic analysis of BRCA mutation carriers undergoing risk-reducing bilateral salpingo-oophorectomy (RRBSO), where a high percentage of incidentally diagnosed cancers and cancer precursor lesions were discovered in the distal fallopian tube ( Herzog and Dinkelspiel, 2013, Crum et al., 2012 and Kwon et al., 2013). These findings have enlivened the discussion on the appropriate management of women at high risk for ovarian cancer, proposing risk-reducing bilateral salpingectomy with delayed bilateral oophorectomy as a reasonable alternative to RRBSO and a means to diminish postoperative sequelae related to estrogen-deficiency.....