Prevalence of occult gynecologic malignancy at the time of risk reducing and nonprophylactic surgery in patients with Lynch syndrome

Intra‐operative evaluation of prophylactic hysterectomy and salpingo‐oophorectomy specimens in hereditary gynaecological cancer syndromes

“…did not identify any occult ovarian carcinomas among 37 and 24 prophylactic salpingo‐oophorectomy (uni‐ or bilateral) specimens, respectively . Two other series reported one occult ovarian carcinoma each, both showing a mixed endometrioid and clear cell histology . We did not observe incidental ovarian carcinomas among our LS cases.…”

“…Occult ovarian carcinoma has been observed previously in 0–4% of prophylactic BSO specimens in LS . Bartosch et al .…”

“…A few recent studies looked at the gross and microscopic characteristics of prophylactic hysterectomy specimens for Lynch syndrome and reported abnormal endometrial histology (including hyperplasia) in up to 32% of cases, with occult endometrial adenocarcinoma in 8–12.5% of cases . All endometrial adenocarcinomas in these studies were of low‐grade (grades 1 or 2) endometrioid type, and all but one case were FIGO (International Federation of Gynaecology and Obstetrics) Stage I . A corresponding gross lesion (‘tumour’ or endometrial thickening) was described in the majority of cases with reported gross findings .…”

“…Occult endometrial cancer has been reported in 8–12.5% of prophylactic hysterectomy specimens for LS in previous series, and up to 32% of specimens showed abnormal histology, including endometrial hyperplasia . Incidental ovarian cancer in LS is less common, with a reported incidence ranging between 0 and 4% . Some authors have pointed out the lack of standardised grossing protocols in these cases and suggested complete submission of endometrium, including the lower uterine segment, in prophylactic hysterectomy specimens for LS .…”

Identifying Lynch Syndrome in Women Presenting With Endometrial Carcinoma Under the Age of 50 Years

“…14 Identification of LS patients and their families is important because of the established survival benefits of CRC screening, 15 along with the suggested survival benefits from prophylactic hysterectomy and oophorectomy. 16 The emerging evidence on the effectiveness of chemoprevention (oral contraceptive pill, aspirin, and nonsteroidal anti-inflammatory drugs) for ovarian cancer and EC 17Y19 raises the potential of early implementation of risk reduction strategies.…”