Occult fallopian tube cancer in a patient with BRCA1 breast cancer

Primary fallopian tube cancer is very rare form of ovarian cancer. However, despite the infrequent incidence, emerging evidence suggests that patients who have a deleterious mutation of BRCA1 or -2 mutation may be more vulnerable to developing this disease. A patient with breast carcinoma was initially treated for her disease in 1994. She had a new primary lesion on the contralateral side in 2001 and was eventually identified with a positive BRCA1 germline mutation in 2007. The patient subsequently underwent a laparoscopic-assisted vaginal hysterectomy and bilateral salpingo-oophorectomy surgery performed by her gynecologist. Final pathology revealed occult stage IIC fallopian tube cancer with bilateral ovarian serosal involvement. Consequently, the patient was referred to gynecologic oncology and underwent a pelvic and paraaortic lymphadenectomy and laparoscopic omentectomy, followed by chemotherapy. Although fallopian tube cancer is rare, women who are positive for the BRCA mutation are at greater risk for developing this disease. Therefore, physicians should consider the associated risk factors and perform comprehensive risk-reducing surgery and staging when treating these patients.