The most common site of BRCA1/2-associated hereditary ovarian cancer has recently been shown by fimbrioscopy and pathological studies to originate primarily from:

• A Ovarian surface epithelium undergoing malignant transformation at monthly ovulation sites
• B Peritoneal mesothelium undergoing mullerian metaplasia
• C Endometriotic implants within the ovary undergoing clear cell transformation
• D Fimbriated end of the fallopian tube (serous tubal intraepithelial carcinoma — STIC) ✓

Explanation

Current evidence from pathological studies in BRCA1/2 mutation carriers who underwent risk-reducing salpingo-oophorectomy demonstrates that the most common site of origin for high-grade serous carcinoma (the most lethal ovarian cancer type) is serous tubal intraepithelial carcinoma (STIC) at the fimbriated end of the fallopian tube. This is identified by the 'SEE-FIM' (Sectioning and Extensively Examining the FIMbriae) protocol. This tubal origin hypothesis has changed understanding of ovarian carcinogenesis and supports salpingectomy for cancer prevention.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.