Validation of an algorithm for the diagnosis of serous tubal intraepithelial carcinoma
. Int J Gynecol Pathol 2012;31(3):243-53.
Incidental serous tubal intraepithelial carcinoma and early invasive serous carcinoma in the nonprophylactic setting: analysis of a case series.
Diagnosis of serous tubal intraepithelial carcinoma based on morphologic and immunohistochemical features: a reproducibility study.
(71-73) In addition, p53 mutation appears to be an early event in serous carcinogenesis, as identical p53 mutations have been detected in a series of serous EACs and concurrent serous endometrial intraepithelial carcinomas
. (74) Clear cell and endometrioid EACs, on the other hand, most often have a wild-type p53 immunostaining pattern, that is, weak focal staining in tumor cell nuclei (Figure 13, A through D; Table 2).
(227-231) The p53 signature lesion, a serous cancer precursor in the fimbria, is identified by its reactivity with p53 and lack of Ki-67 proliferative activity and cytologic atypia of intraepithelial carcinoma
In 1961, Abell and Gosling  described 2 distinct histopathologic types as intraepithelial carcinoma
of Bowen's type and intraepithelial carcinoma
By applying the criteria used to classify ovarian mucinous cystic neoplasms, these areas were designated as foci of intraepithelial carcinoma, on the basis of the presence of severe cytologic atypia.
They contrast with the largely intracystic growth seen in our case whose spectrum, for the same lesion, ranged from cystadenoma to a borderline lesion to intraepithelial carcinoma, much like ovarian mucinous tumors.
It is in specimens such as these that the pathologist is particularly likely to miss the presence of an endometrial intraepithelial carcinoma
, the putative precursor of invasive serous (and perhaps clear cell) adenocarcinoma of the endometrium.
(*) To avoid confusion with the term carcinoma in situ as it applies to pTis in the TNM staging (see note F), the term intraepithelial carcinoma
should be used to refer to histologically malignant epithelium that does not penetrate the basement membrane (ie, shows no evidence of stromal [lamina propria] invasion).[5,6]
Although most of these occult carcinomas involve the tubal fimbriae, and are tubal intraepithelial carcinomas
(TICs), (2-4) other sites, such as the midportion of the isthmus, are also involved.
Because of the emphasis placed on hyperplasias in the conventional classification of intraductal proliferative lesions, the role of this lesion in mammary carcinogenesis was totally ignored by many pathologists in the United States until its neoplastic nature and similarity to low-grade invasive and intraepithelial carcinomas
at the molecular level was demonstrated in our laboratory in 2000.