Cellular escape artists help explain why some women present with advanced ovarian cancer
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More than two-thirds of women with ovarian cancer have high-grade serous carcinoma (HGSC). Up to 90 percent of HGSCs are not detected until they are beyond the ovaries or fallopian tubes, at which point it may not be possible to fully remove the tumor. Many of these cancers are now known to originate in the fallopian tube, which is the site where almost all early HGSCs are discovered in healthy women undergoing resection of fallopian tubes. In contrast, among women who first come into the clinic with symptoms of advanced HGSC that has already spread beyond the gynecological region, clinicians can often find little or no evidence of malignancy in the fallopian tubes. Christopher Crum, MD, in the BWH Division of Women’s and Perinatal Pathology, describes this as the great mystery of HGSC.

“I’ve always been perplexed by the cases where women present with advanced HGSC out of the blue, and we don’t detect anything in the fallopian tube,” said Crum. “This is a fundamental mystery: Why do we catch the cancer so late even when we thought we were catching it early?”

In a new study published recently in the Journal of Pathology, Crum and colleagues conducted an

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