BRCA1-associated ovarian cancer has which characteristic histological type and site of origin?
- A High-grade serous carcinoma (HGSC) arising from the fimbrial end of the fallopian tube (STIC lesion) ✓
- B Endometrioid carcinoma arising from ovarian surface epithelium
- C Clear cell carcinoma arising from endometriosis
- D Mucinous carcinoma of primary ovarian origin
Correct answer: A. High-grade serous carcinoma (HGSC) arising from the fimbrial end of the fallopian tube (STIC lesion)
Explanation
BRCA1 and BRCA2 mutations are most strongly associated with high-grade serous carcinoma (HGSC), which molecular evidence shows arises predominantly from the fimbrial epithelium of the fallopian tube as a serous tubal intraepithelial carcinoma (STIC) that then spreads to the ovary and peritoneum. This is why risk-reducing salpingo-oophorectomy in BRCA carriers specifically removes the fallopian tube as the primary site. Clear cell and endometrioid carcinomas arise from endometriosis; mucinous carcinomas are often metastatic.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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