Philippine E-Journals

Expect the Unexpected: A Rare Case of Serous Tubal Intraepithelial Carcinoma in Gestational Tubal Pregnancy

Jeanne Alyxis D. Jasmin | Judith G. Cabanela

Discipline: medical sciences (non-specific)

 

Abstract:

STIC (Serous Tubal Intraepithelial Carcinoma) is a rare pathologic finding in the fallopian tube at the time of benign gynecological surgery. It is an abnormal growth of stratified non-ciliated cells. It is associated with 50%–60% of high-grade serous pelvic carcinomas and discovered in 5-10% of asymptomatic BRCA-1,2 mutation carriers. STIC usually arises in the tube when it is unilateral and shows variable atypia of low-grade to high-grade in the background of absent advanced disease. The incidence of STIC is estimated to occur in 0.6% to 6% of women who are BRCA positive or have a strong family history of breast or ovarian cancer. The reliability of the diagnosis is greatly enhanced by combining histology with immunohistochemistry expression of p53 and ki67. STIC arises in the distal fimbriated end of the fallopian tube and likely represents a precursor lesion to high-grade pelvic serous carcinoma. Primary cancer of the fallopian tube is a rare malignancy of the female genital tract. It accounts for 0.1–1.8% of all gynecological cancers diagnosed. Ectopic tubal gestation and STIC rarely occur together. The partial tube occlusion caused by STIC is one potential cause of tubal gestation. We report a case of a 26 years old woman with an incidental finding of serous tubal intraepithelial carcinoma, who underwent exploratory laparotomy with left salpingectomy for ectopic pregnancy, ampullary, left, ruptured. We aim to discuss a rare case of STIC in ectopic pregnancy, its post operative management and the future plans for such condition.