A 55-year-old woman undergoes prophylactic bilateral salpingo-oophorectomy after testing BRCA2 positive. The ovaries and tubes are sent for histopathological examination. The pathologist performs the SEE-FIM (Sectioning and Extensively Examining the Fimbria) protocol. This protocol targets which occult malignancy?
- A Ovarian serous carcinoma originating from the surface epithelium
- B Endometrioid carcinoma of the ovary
- C High-grade serous tubal carcinoma originating from the fimbrial end of the Fallopian tube ✓
- D BRCA-associated peritoneal carcinoma
Correct answer: C. High-grade serous tubal carcinoma originating from the fimbrial end of the Fallopian tube
Explanation
The SEE-FIM protocol was developed after evidence showed that most high-grade serous carcinomas (HGSC) thought to be of ovarian origin actually originate in the fimbrial end of the Fallopian tube (from serous tubal intraepithelial carcinoma — STIC). BRCA carriers have a high risk of fimbrial STIC lesions. This protocol involves extensive sectioning of the fimbria at 2–3 mm intervals and submitting all sections for histology to detect occult carcinoma or STIC, which may be missed on standard sectioning.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.