How would you manage a patient with an incidental finding of 1 mm focus of high-grade serous carcinoma in the fallopian tube after TAHBSO was done for a benign broad ligament fibroid with negative pelvic washings?

Occult serous tubal intraepithelial carcinoma (STIC) lesions have been reported in 0.7-7.0% of BRCA mutation carriers undergoing risk-reducing salpingo-oophorectomy and invasive malignancy has been reported in 1-4% of cases.¹ The reported incidence of serous tubal intraepithelial carcinoma (STIC) in women undergoing surgery for a benign gynecologic indication is <1%. Incidental occult invasive serous fallopian tube cancer is rare in this population.

Pathology Issues:

With the unexpected diagnosis...