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Familial Cancer and Prophylactic Surgery

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Diagnostic Pathology of Ovarian Tumors

Abstract

Familial ovarian cancers account for approximately 10% of all ovarian cancers. The vast majority of familial ovarian cancer arises in the setting of well-defined genetic syndromes such as BRCA1 and BRCA2 mutations, Lynch syndrome, and Peutz–Jeghers syndrome. BRCA1 and BRCA2 carriers may undergo risk-reducing salpingo-oophorectomy (RRSO). This chapter explains the criteria for RRSO, informs the reader about the examination and classification of specimens obtained from RRSO, including serous tubal intraepithelial lesion and p53 signature lesion, and describes the management and outcome of patients following RRSO.

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References

  1. Tavassoli FA, Devilee P, editors. Tumours of the breast and female genital organs. Lyon: IARC; 2003.

    Google Scholar 

  2. Vang R, Shih IeM, Kurman RJ. Ovarian low-grade and high-grade serous carcinoma: pathogenesis, clinicopathologic and molecular biologic features, and diagnostic problems. Anat Pathol. 2009;16(5):267–82.

    Article  Google Scholar 

  3. Lavie O, Neuman M, Rosemann E, Diamant Y. Serous papillary adenocarcinoma of the endometrium. A unique entity with a grave prognosis. Case report and review of the literature. Eur J Gynaecol Oncol. 1993;14(1):46–50.

    PubMed  CAS  Google Scholar 

  4. Medeiros F, Muto MG, Lee Y, Elvin JA, Callahan MJ, Feltmate C, et al. The tubal fimbria is a preferred site for early adenocarcinoma in women with familial ovarian cancer syndrome. Am J Surg Pathol. 2006;30:230–6.

    Article  PubMed  Google Scholar 

  5. Pothuri B, Leitao M, Levine DA, et al. Genetic analysis of the early natural history of epithelial ovarian carcinoma. PLoS ONE. 2010;26:e10358.

    Article  Google Scholar 

  6. Kurman RJ, Shih IeM. The origin and pathogenesis of epithelial ovarian cancer: a proposed unifying theory. Am J Surg Pathol. 2010;34:433–43.

    Article  PubMed  Google Scholar 

  7. Jarboe E, Folkins A, Nucci MR, et al. Serous carcinogenesis in the fallopian tube: a descriptive classification. Int J Gynecol Pathol. 2008;27(1):1–9.

    Article  PubMed  Google Scholar 

  8. Hendrickson MR, Kempson RL. Normal histology of the uterus and fallopian tubes. In: Sternberg SS, editor. Histology for pathologists. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 1997. p. 879–928.

    Google Scholar 

  9. Rabban JT, Crawford B, Chen LM, Powell CB, Zaloudek CJ. Transitional cell metaplasia of fallopian tube fimbriae: a potential mimic of early tubal carcinoma in risk reduction salpingo-oophorectomies from women With BRCA mutations. Am J Surg Pathol. 2009;33(1):111–9.

    Article  PubMed  Google Scholar 

  10. Stern J, Buscema J, Parmley T, Woodruff JD, Rosenshein NB. Atypical epithelial proliferations in the fallopian tube. Am J Obstet Gynecol. 1981;140(3):309–12.

    PubMed  CAS  Google Scholar 

  11. Lee Y, Miron A, Drapkin R, et al. A candidate precursor to serous carcinoma that originates in the distal fallopian tube. J Pathol. 2007;211(1):26–35.

    Article  PubMed  CAS  Google Scholar 

  12. Olivier RI, van Beurden M, Lubsen MA, et al. Clinical outcome of prophylactic oophorectomy in BRCA1/BRCA2 mutation carriers and events during follow-up. Br J Cancer. 2004;90(8):1492–7.

    Article  PubMed  CAS  Google Scholar 

  13. Callahan MJ, Crum CP, Medeiros F, et al. Primary fallopian tube malignancies in BRCA-positive women undergoing surgery for ovarian cancer risk reduction. J Clin Oncol. 2007;25(25):3985–90.

    Article  PubMed  Google Scholar 

  14. Auersperg N, Woo MM, Gilks CB. The origin of ovarian carcinomas: a developmental view. Gynecol Oncol. 2008;110(3):452–4.

    Article  PubMed  Google Scholar 

  15. Lynch HT, Casey MJ, Snyder CL, Bewtra C, Lynch JF, Butts H, et al. Hereditary ovarian carcinoma: heterogeneity, molecular genetics, pathology, and management. Mol Oncol. 2009;3:97–137.

    Article  PubMed  CAS  Google Scholar 

  16. Lu KH, Garber JE, Cramer DW, et al. Occult ovarian tumors in women with BRCA1 or BRCA2 mutations undergoing prophylactic oophorectomy. J Clin Oncol. 2000;18(14):2728–32.

    PubMed  CAS  Google Scholar 

  17. Colgan TJ, Murphy J, Cole DE, Narod S, Rosen B. Occult carcinoma in prophylactic oophorectomy specimens: prevalence and association with BRCA germline mutation status. Am J Surg Pathol. 2001;25(10):1283–9.

    Article  PubMed  CAS  Google Scholar 

  18. Leeper K, Garcia R, Swisher E, Goff B, Greer B, Paley P. Pathologic findings in prophylactic oophorectomy specimens in high-risk women. Gynecol Oncol. 2002;87(1):52–6.

    Article  PubMed  Google Scholar 

  19. Powell CB, Kenley E, Chen LM, et al. Risk-reducing salpingo-oophorectomy in BRCA mutation carriers: role of serial sectioning in the detection of occult malignancy. J Clin Oncol. 2005;23(1):127–32.

    Article  PubMed  Google Scholar 

  20. Carcangiu ML, Peissel B, Pasini B, Spatti G, Radice P, Manoukian S. Incidental carcinomas in prophylactic specimens in BRCA1 and BRCA2 germ-line mutation carriers, with emphasis on fallopian tube lesions: report of 6 cases and review of the literature. Am J Surg Pathol. 2006;30(10):1222–30.

    Article  PubMed  Google Scholar 

  21. Shaw PA, Rouzbahman M, Pizer ES, Pintilie M, Begley H. Candidate serous cancer precursors in fallopian tube epithelium of BRCA1/2 mutation carriers. Mod Pathol. 2009;22(9):1133–8.

    Article  PubMed  CAS  Google Scholar 

  22. Lamb JD, Garcia RL, Goff BA, Paley PJ, Swisher EM. Predictors of occult neoplasia in women undergoing risk-reducing salpingo-oophorectomy. Am J Obstet Gynecol. 2006;194(6):1702–9.

    Article  PubMed  Google Scholar 

  23. Hirst JE, Gard GB, McIllroy K, Nevell D, Field M. High rates of occult fallopian tube cancer diagnosed at prophylactic bilateral salpingo-oophorectomy. Int J Gynecol Cancer. 2009;19:826–9.

    Article  PubMed  Google Scholar 

  24. Kauff ND, Satagopan JM, Robson ME, et al. Risk-reducing salpingo-oophorectomy in women with a BRCA1 or BRCA2 mutation. N Engl J Med. 2002;346(21):1609–15.

    Article  PubMed  Google Scholar 

  25. Rebbeck TR, Lynch HT, Neuhausen SL, et al. Prevention and observation of surgical end points study group prophylactic oophorectomy in carriers of BRCA1 or BRCA2 mutations. N Engl J Med. 2002;346(21):1616–22.

    Article  PubMed  Google Scholar 

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Colgan, T.J., Chang, M.C. (2011). Familial Cancer and Prophylactic Surgery. In: Soslow, R., Tornos, C. (eds) Diagnostic Pathology of Ovarian Tumors. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-9751-7_18

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  • DOI: https://doi.org/10.1007/978-1-4419-9751-7_18

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-9750-0

  • Online ISBN: 978-1-4419-9751-7

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