Gynecologic cancerThe distal fallopian tube: a new model for pelvic serous carcinogenesisCrum, Christopher P; Drapkin, Ronny; Miron, Alexander; Ince, Tan A; Muto, Michael; Kindelberger, David W; Lee, YongheeAuthor Information Division of Women's and Perinatal Pathology, Department of Pathology, and Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, and the Divisions of Cancer Medicine and Cancer Biology, Dana Farber Cancer Institute, Boston, Massachusetts, USA Correspondence to Christopher P. Crum, MD, Department of Pathology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, USA Tel: +617 732 5481; fax: +617 264 5125; e-mail: email@example.com Current Opinion in Obstetrics and Gynecology: February 2007 - Volume 19 - Issue 1 - p 3-9 doi: 10.1097/GCO.0b013e328011a21f Buy SDC Metrics Abstract Purpose of review Research over the past 50 years has yielded little concrete information on the source of pelvic serous cancer in women, creating a knowledge gap that has adversely influenced our ability to identify, remove or prevent the earliest stages of the most lethal form of ovarian cancer. Recent findings The distal fallopian tube is emerging as an established source of many early serous carcinomas in women with BRCA mutations (BRCA+). Protocols examining the fimbrial (SEE-FIM) end have revealed a noninvasive but potentially lethal form of tubal carcinoma, designated tubal intraepithelial carcinoma. Tubal intraepithelial carcinoma is present in many women with presumed ovarian or peritoneal serous cancer. A candidate precursor to tubal intraepithelial carcinoma, entitled the ‘p53 signature’, suggests that molecular events associated with serous cancer (p53 mutations) may be detected in benign mucosa. Summary A fully characterized precursor lesion is a first and necessary step to pelvic serous cancer prevention. The emerging data offer compelling evidence for a model of ‘fimbrial-ovarian’ serous neoplasia, and call attention to the distal fallopian tube as an important source for this disease, the study of which could clarify pathways to cancer in both organs and generate novel strategies for cancer prevention. © 2007 Lippincott Williams & Wilkins, Inc.