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Preoperative screening endometrial cytology discovered incidental gynaecological malignancy in two patients undergoing risk-reducing salpingo-oophorectomy
  1. Riho Kojima,
  2. Masafumi Toyoshima,
  3. Akihito Yamamoto and
  4. Shunji Suzuki
  1. OB-GY, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
  1. Correspondence to Dr Masafumi Toyoshima; m-toyoshima{at}


Pelvic ultrasonography and measurement of serum cancer antigen 125 (CA-125) are recommended for preoperative evaluation before performing risk-reducing salpingo-oophorectomy (RRSO). We report our experience with two patients in whom an incidental gynaecological malignancy was found using endometrial cytology as a preoperative screening test for RRSO. Patient 1 was an early 50s woman with a pathologic variant of BRCA1. Transvaginal ultrasonography showed no endometrial abnormalities, but preoperative endometrial cytology revealed high-grade serous carcinoma. The patient underwent total hysterectomy, bilateral adnexectomy, pelvic and para-aortic lymph node dissection, and omentectomy. Patient 2 was a late 40s woman with a pathological variant of BRCA1. Transvaginal ultrasonography showed mild enlargement of the left ovary, and her CA-125 level was elevated. Preoperative endometrial cytology revealed high-grade serous cancer. She underwent total hysterectomy, bilateral adnexectomy and omentectomy. These case reports illustrate the importance of preoperative screening—including endometrial cytology—before performing RRSO.

  • Gynecological cancer
  • Obstetrics, gynaecology and fertility
  • Cancer intervention

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  • Contributors RK: data curation and writing of the original draft. MT: conceptualisation, data curation, investigation, writing of the original draft, draft review and editing. AY: investigation. SS: supervision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.