信州医学雑誌
Online ISSN : 1884-6580
Print ISSN : 0037-3826
ISSN-L : 0037-3826
症例
腹腔鏡下リスク低減卵管卵巣摘出術により両側卵管采に漿液性卵管上皮内病変が発見された遺伝性乳癌卵巣癌症候群の1例
鹿島 大靖岡 賢二品川 真奈花山中 桜小野 元紀竹内 穂高井田 耕一樋口 正太郎山田 靖小原 久典菊地 範彦宮本 強橘 涼太福嶋 義光古庄 知己家里 明日美伊藤 研一浅香 志穂上原 剛塩沢 丹里
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2019 年 67 巻 3 号 p. 209-215

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A 42-year-old woman, gravida 1 para 1, was referred to our hospital on suspicion of hereditary breast and ovarian cancer syndrome (HBOC) due to her medical and family history. Genetic testing revealed a germline BRCA1 mutation. She was diagnosed with HBOC, and decided to undergo risk-reducing salpingo-oophorectomy (RRSO). There was no abnormal macroscopic finding in the pelvis and abdomen, and laparoscopic RRSO (LRRSO) was performed uneventfully. Pathological examination revealed mildly atypical epithelium with high p53 and low Ki-67 expression in fimbriae of the bilateral fallopian tubes and a diagnosis of serous tubal intraepithelial lesion (STIL).
Serous tubal intraepithelial carcinoma (STIC) is considered to be a premalignant lesion of ovarian serous carcinoma. In the present case, we found STIL, which is presumed to be a precursor lesion of STIC, in bilateral fimbrial epithelia of the fallopian tubes resected by LRRSO. Therefore, LRRSO is considered to be an effective prophylactic treatment for HBOC patients.

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