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Ginecología y obstetricia de México
versión impresa ISSN 0300-9041
Resumen
LUQUE-GONZALEZ, Pablo et al. Seuous tubal intraepithelial carcinoma as a post-surgical finding of endometriosis and myomatous uterus. A case report. Ginecol. obstet. Méx. [online]. 2020, vol.88, n.9, pp.625-631. Epub 04-Oct-2021. ISSN 0300-9041. https://doi.org/10.24245/gom.v88i9.4081.
BACKGROUND:
Serous tubal intraepithelial carcinoma (STIC) is a precursor lesion of invasive high-grade tubal and serous carcinoma of the ovary, frequently diagnosed in the context of prophylactic bilateral salpingoophorectomy for benign gynecological pathology. The objective of this work is to carry out a literature review on the most relevant aspects of the follow-up of this injury, after its incidental diagnosis in gynecological surgery.
CLINICAL CASE:
A 51-year-old nulliparous patient who, in the context of a clinical situation of abdominal pain with elevation of tumor markers CA125 and CA19.9, was diagnosed with polymomatous uterus and suspected endometrioma in the right ovary. After a subtotal hysterectomy with bilateral adnexectomy, the histological study of the excised tubal specimen found microscopic foci of STIC without signs of stromal invasion. Given this finding, breast imaging tests and a genetic study of the BRCA 1/2 mutation was requested.
CONCLUSION:
Prophylactic bilateral salpingoophorectomy in gynecological surgery is a procedure that can reduce the risk of developing peritoneal, tubal, and serous ovarian carcinomas. Patients diagnosed with STIC should be subsidiaries of follow-up based on ultrasound controls, mammary imaging tests, tumor markers, and genetic studies, due to their association in many cases with mutations in the BRCA 1/2 genes. It is necessary to establish a series of standardized clinical protocols for the management of patients with STIC and to continue advancing our understanding of this pathology and its subsequent evolution to high-grade serous carcinoma.
Palabras llave : Serous tubal intraepithelial carcinoma; Ovary; Abdominal pain; Tumor markers; Endometrioma; subtotal hysterectomy; BRCA 1/2 mutations; Clinical protocols.