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The Origins of Ovarian Cancer: A Prospective Study to Decipher the Precursor Lesions of Surface Epithelial Neoplasms

G. Mahantesh, Resident, Department of Pathology, Guntur Medical College, Guntur, Andhra Pradesh 522004, India. , C. Padmavathi Devi1 , G. Mahantesh2

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Indian Journal of Obstetrics and Gynecology 6(4):p 367-371, July - August 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijog.2321.1636.6418.5

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Abstract

Introduction: The rapidly accumulating advances in the field of Pathology lead to the evolution of newer models of Ovarian carcinogenesis, that classify Surface Epithelial tumors into Type-I and Type-II. Type-I are those ovarian tumors, where precursor lesions in the ovary have clearly been described. Type II tumors are those, where such lesions have not been described clearly and tumors  may develop de novo from the tubal and/or ovarian surface epithelium, comprising of high grade carcinomas, causing significant mortality. Hence, we undertook the study to identify the precursor lesions of these malignant neoplasms and provide a road-map for early diagnosis.

Aim: To study the morphological spectrum of ovarian surface epithelial neoplasms with emphasis on tumorogenesis of malignant tumors.

Materials and Methods: This is a prospective study conducted from July 2015 to July 2017. Cases diagnosed as Ovarian tumors were included in the present study, with special emphasis on extensive examination of fallopian tubes using SEE-FIM protocol.

Results: Out of 133 cases of Surface Epithelial tumors, malignant tumors accounted for 25 cases and  were associated with Serous Tubal Intraepithelial Carcinoma (STIC) in three cases and ‘Atypical changes’ in two cases.

Conclusion: The Serous Tumors of the Ovary, may have an identifiable precursor lesion in the form of STIC arising from the fallopian tube, more commonly from the TuboPeritoneal Junction at the fimbrial end.

Keywords: Surface Epithelial; Ovary; STIC; Atypical Changes; Malignant; Serous Carcinoma; Tubo-Peritoneal Junction; Fimbrial; Precursor Lesion.

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DOI: DOI: http://dx.doi.org/10.21088/ijog.2321.1636.6418.5

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