BRCA1/2 mutation carriers undergoing risk-reducing salpingo-oophorectomy (RRSO): which pathological finding on the 'SEE-FIM' protocol is considered the precursor lesion for high-grade serous carcinoma?

• A Cortical inclusion cysts in the ovary
• B Serous tubal intraepithelial carcinoma (STIC) in the fimbriae ✓
• C Endosalpingiosis of the peritoneum
• D Paratubal cysts adjacent to the fimbriae

Explanation

The SEE-FIM (Sectioning and Extensively Examining the FIMbriated end) protocol was designed to detect STIC, the non-invasive precursor lesion for high-grade serous carcinoma of the ovary/tube/peritoneum. STIC arises in the fallopian tube fimbriae, with p53 signature mutations, and is found in ~6% of BRCA carriers undergoing RRSO. This supports the tubal origin theory of most 'ovarian' high-grade serous carcinomas.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.