The distal fallopian tube: a new model for pelvic serous carcinogenesis.
OBJECTIVE
Research over the past 50 years has yielded little concrete information on the source of pelvic serous cancer in women, creating a knowledge gap that has adversely influenced our ability to identify, remove or prevent the earliest stages of the most lethal form of ovarian cancer.


RESULTS
The distal fallopian tube is emerging as an established source of many early serous carcinomas in women with BRCA mutations (BRCA+). Protocols examining the fimbrial (SEE-FIM) end have revealed a noninvasive but potentially lethal form of tubal carcinoma, designated tubal intraepithelial carcinoma. Tubal intraepithelial carcinoma is present in many women with presumed ovarian or peritoneal serous cancer. A candidate precursor to tubal intraepithelial carcinoma, entitled the 'p53 signature', suggests that molecular events associated with serous cancer (p53 mutations) may be detected in benign mucosa.


CONCLUSIONS
A fully characterized precursor lesion is a first and necessary step to pelvic serous cancer prevention. The emerging data offer compelling evidence for a model of 'fimbrial-ovarian' serous neoplasia, and call attention to the distal fallopian tube as an important source for this disease, the study of which could clarify pathways to cancer in both organs and generate novel strategies for cancer prevention.
Crum
Christopher P
CP
Division of Women's and Perinatal Pathology, Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. ccrum@partners.org
Drapkin
Ronny
R
Miron
Alexander
A
Ince
Tan A
TA
Muto
Michael
M
Kindelberger
David W
DW
Lee
Yonghee
Y
D002288:Adenocarcinoma, Mucinous / Q000209:etiology* / Q000473:pathology; D002278:Carcinoma in Situ / Q000209:etiology / Q000473:pathology; D002471:Cell Transformation, Neoplastic; D005185:Fallopian Tube Neoplasms / Q000235:genetics / Q000473:pathology*; D005260:Female; D019398:Genes, BRCA1; D006801:Humans; D010051:Ovarian Neoplasms / Q000209:etiology / Q000473:pathology; D010534:Peritoneal Neoplasms / Q000209:etiology* / Q000473:pathology; D011230:Precancerous Conditions / Q000235:genetics / Q000473:pathology; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism
D016159:Tumor Suppressor Protein p53