Some Fallopian Tube Lesions Represent Ovarian Cancer Metastases, Not Precursor Lesions

(Dec. 21, 2016) Research published recently in Cancer Discovery suggests that cells in the fallopian tube previously thought to be precursors to high grade serous ovarian cancer may sometimes be cells that have metastasized and implanted into the fallopian tube. The research was conducted by a team at the University of Chicago under the guidance of OCRFA Scientific Advisory Committee member and former grantee Dr. Ernst Lengyel.

Accumulating evidence has supported the fallopian tube rather than the ovary as the origin for high-grade serous ovarian cancer (HGSOC). To understand the relationship between putative precursor lesions and metastatic tumors, researchers examined specimens from eight HGSOC patients, consisting of serous tubal intraepithelial carcinomas (STIC), invasive fallopian tube lesions, invasive ovarian lesions, and omental metastases. Analysis suggested that STIC possess most of the genomic aberrations present in advanced cancers. STIC were precursor lesions in half of the patients, but in two patients, STIC were identified as metastases.

This research provides further insight into the development of HGSOC, and suggests that STIC may represent either primary precursor lesions or secondary metastases in patients with HGSOC.

In an accompanying commentary, Dr. Elizabeth Swisher et. al. comment, “Understanding the origin of pelvic carcinomas is critically important for optimizing cancer prevention strategies at both the individual and population levels. In studying the origin of HGSC, it remains important to separate cases driven by germline mutations in BRCA1/2 or other ovarian cancer susceptibility genes from sporadic carcinomas. Eckert and colleagues have made a seminal contribution to our understanding by providing genomic and experimental data supporting the ability of at least some sporadic HGSC to secondarily implant into the fallopian tube mucosa.”

Read more in Cancer Discovery here.