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The perforin/granzyme system, just like with the FAS/FASL system,requires cell-to-cell contact, but as will be explained shortly, in this case there is intimatecontact between the effector and target in such a way that allows the effector to remodel thetargets outer cell membrane. The latter, in particular, has shownan excellent sensitivity and a very high specificity before surgical treatment

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Occasionally, however, one may befertilized and implant in the peritoneal cavity on the surface ofthe ovary or intestine orinside the rectouterine (Douglas) pouch.Such ectopic implantations usually do not develop beyondearly fetal stages but may have to be removed surgically.

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