1
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Ho MJ, Kyang LS, Schlichtemeier S. Bowel perforation with generalised peritonitis secondary to recurrent primary fallopian tube carcinoma after 17 years. BMJ Case Rep 2024; 17:e258764. [PMID: 38642935 PMCID: PMC11033654 DOI: 10.1136/bcr-2023-258764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2024] Open
Abstract
We describe a case of bowel perforation secondary to a recurrence of primary fallopian tube carcinoma treated more than a decade ago. A woman in her 70s presented to a rural centre with an acute abdomen. An abdominal CT showed a perforated ileum secondary to a pelvic mass. Emergency laparotomy identified the pelvic mass that was adherent to the side wall and invading the ileum at the site of perforation. Its adherence to the external iliac vessels posed a challenge to achieve en-bloc resection; therefore, a defunctioning loop ileostomy was created. Final histopathology and immunopathology were consistent with the recurrence of her primary fallopian tube carcinoma. The patient was further discussed in a multidisciplinary team meeting at a tertiary referral hospital. This case highlighted the importance of having a high index of suspicion for cancer recurrence, the utility of rapid source control laparotomy and multidisciplinary team patient management.
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Affiliation(s)
- Mei Jing Ho
- General Surgery, Nepean Blue Mountains Local Health District, Kingswood, New South Wales, Australia
| | - Lee S Kyang
- General Surgery, St Vincent's Health Australia Ltd, Darlinghurst, New South Wales, Australia
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2
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Nguyen BT, Lundeberg KR, Lo NW, Findley A, Riggs MJ, Nagy KE. Primary fallopian tube carcinoma diagnosed 29 years after bilateral partial salpingectomy: A case report. Int J Gynaecol Obstet 2024. [PMID: 38379441 DOI: 10.1002/ijgo.15436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 12/22/2023] [Accepted: 02/04/2024] [Indexed: 02/22/2024]
Abstract
SynopsisSalpingectomy has a reported theoretical decreased risk of tubal and ovarian cancers. Here we describe a case 29 years after partial salpingectomy.
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Affiliation(s)
- Bao T Nguyen
- The Department of Gynecologic Surgery and Obstetrics, Wright Patterson Medical Center, Wright Patterson AFB, Ohio, USA
| | - Kathleen R Lundeberg
- The Department of Gynecologic Surgery and Obstetrics, Wright Patterson Medical Center, Wright Patterson AFB, Ohio, USA
| | - Nancy W Lo
- The Department of Gynecologic Surgery and Obstetrics, Wright Patterson Medical Center, Wright Patterson AFB, Ohio, USA
| | - Austin Findley
- The Department of Gynecologic Surgery and Obstetrics, Wright Patterson Medical Center, Wright Patterson AFB, Ohio, USA
| | - McKayla J Riggs
- The Department of Gynecologic Surgery and Obstetrics, Wright Patterson Medical Center, Wright Patterson AFB, Ohio, USA
| | - Kelly E Nagy
- The Department of Gynecologic Surgery and Obstetrics, Wright Patterson Medical Center, Wright Patterson AFB, Ohio, USA
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3
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Liu Y, Huang F, Gu Q, Wang J, Wang Q, Wu Y, Li L, Xiao Y. Lymphadenectomy and optimal excise lymph nodes count for early-stage primary fallopian tube cancer: a SEER-based study. BMC Womens Health 2023; 23:681. [PMID: 38129825 PMCID: PMC10740229 DOI: 10.1186/s12905-023-02833-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUNDS There is still no consensus on the significance of Lymphadenectomy (LD) and the number of lymph nodes that need to be excised (ELNs) for adequate LD in patients with early-stage primary fallopian tube cancer (PFTC). Our endeavor is geared towards deepening comprehension of LD in early-stage PFTC and identify the optimal cut-off of ELNs. METHODS This SEER-based study analyzed the clinical data of patients with early-stage PFTC between 2000 and 2018. X-tile was employed to confirm the optimal cut-off of ELNs. The survival data between groups were analyzed by the Kaplan-Meier estimates, Log-rank test and Cox proportional hazards model. RESULTS There was significant improvement in both mean cancer-specific survival (CSS, p < 0.001) and overall survival (OS, p < 0.001) in LD group. Regardless of matched or not, LD was identified as an independent protective factor of CSS and OS. The optimal 3-year CSS-based cutoff of ELNs was 11 (p = 0.026) as determined by X-tile. Both the mean CSS (p = 0.001) and mean OS (p = 0.002) in adequate LD group (ELNs > 11, n = 574) were significantly longer than these in inadequate LD group (ELNs ≤ 11, n = 738). Adequate LD, FIGO stage, tumor grade and histology were significant prognostic factors for CSS and OS. CONCLUSION LD is an independent protective prognostic factor of patients with early-stage PFTC. The association between ELNs > 11 and an improved prognosis is evident. Future studies are needed to further clarify the results above.
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Affiliation(s)
- Yuexi Liu
- Department of Obstetrics and Gynecology, The first Affiliated Hospital of Chongqing Medical university, Chongqing, China
| | - Fanfan Huang
- Department of Ophthalmology, The first Affiliated Hospital of Chongqing Medical university, Chongqing, China
| | - Qiuying Gu
- Department of Obstetrics and Gynecology, The first Affiliated Hospital of Chongqing Medical university, Chongqing, China
| | - Jinlong Wang
- Department of Obstetrics and Gynecology, The first Affiliated Hospital of Chongqing Medical university, Chongqing, China
| | - Qingmiao Wang
- Department of Obstetrics and Gynecology, The first Affiliated Hospital of Chongqing Medical university, Chongqing, China
| | - Yuyang Wu
- Chongqing Medical university, Address No. 1, Medical College Road, Chongqing, Yuzhong District, 400016, China
| | - Lijuan Li
- Department of Gynecologic Oncology, School of Medicine, the International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, China.
| | - Yao Xiao
- Chongqing Medical university, Address No. 1, Medical College Road, Chongqing, Yuzhong District, 400016, China.
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Joshi JS, Shanoo A, Dave A, Patel N. Primary Fallopian Tube Carcinoma Presenting as a Broad Ligament Fibroid: A Rare Case. Cureus 2023; 15:e49142. [PMID: 38130542 PMCID: PMC10733614 DOI: 10.7759/cureus.49142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023] Open
Abstract
Primary fallopian tube carcinomas (PFTCs) are quite rare with the incidence ranging from 0.3% to 1.1% amongst all the gynaecological malignancies. Here, we present a rare case of a 44-year-old female (parity-2, live-2 and abortion-2), with one previous classical caesarean section and one vaginal birth after caesarean section (VBAC), bilateral tubal ligation done referred to our gynaecology OPD with complaints of pain in the abdomen since the past six days. The patient also had complaint of spotting per vagina for the past two months. Her ultrasonography and contrast-enhanced CT abdomen and pelvis were suggestive of broad ligament fibroid, which turned out to be a PFTC. Primary fallopian tube malignancies are so rare that this entity may be missed in routine clinical practice and surprisingly noticed during operative procedure or on histopathology reports. Thus, one must be aware of this rare clinical entity and keep it in mind while taking patients on the operating table.
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Affiliation(s)
- Jalormy S Joshi
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Amardeep Shanoo
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Apoorva Dave
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nainita Patel
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Khalloufi C, Joudar I, Kanas A, Benhessou M, Ennachit M, El Kerrroumi M. Atypical adnexal mass misdiagnosed as an ovarian tumor revealing a bilateral tubal cancer. Case report. Int J Surg Case Rep 2023; 105:108030. [PMID: 36989628 PMCID: PMC10074559 DOI: 10.1016/j.ijscr.2023.108030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/09/2023] [Accepted: 03/17/2023] [Indexed: 03/29/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Primary epithelial cancers of the tube are a rare entity. They represent less than 2 % of gynecological tumors and are dominated by adenocarcinoma. Due to its proximity to the uterus and the ovary, the diagnosis of tubal cancer is very difficult to confirm, frequently misdiagnosed as a benign ovarian or tubal pathology. This may explain the underestimation of this cancer. PRESENTATION OF CASE We report a case of a 47 years old patient diagnosed with a pelvic mass, the patient had an hysterectomy with omentectomy revealing a bilateral tubal adenocarcinoma after the histopathological examination. CLINICAL DISCUSSION Tubal adenocarcinoma is a more common pathology in postmenopausal women. The treatment is similar to that for ovarian cancer. Symptoms and the serum CA-125 level may be helpful indicators but are neither specific nor always found. Therefore, careful intraoperative assessment of the adnexa is necessary. CONCLUSION Despite the refinement of diagnostic tools available to clinicians, it is still difficult to diagnose the tumor beforehand. Nonetheless, the diagnosis of tubal cancer must be suspected in the context of a differential diagnosis of an adnexal mass. Abdomino-pelvic ultrasound is the key examination in the diagnostic process and the discovery of a suspicious adnexal mass leads to the performance of a pelvic MRI and, if necessary, to surgical exploration. The therapeutic principles follow those of ovarian cancer. Efforts should be focused on the creation of regional and international registries of tubal cancer cases in order to achieve greater statistical power in future studies.
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Affiliation(s)
- Chadia Khalloufi
- Mohamed VI Oncology Center, Casablanca, Morocco; Faculty of Medicine and Pharmacy, University Hassan II, Ain chock BP 5366, 20000 Casablanca, Morocco.
| | - Imane Joudar
- Mohamed VI Oncology Center, Casablanca, Morocco; Faculty of Medicine and Pharmacy, University Hassan II, Ain chock BP 5366, 20000 Casablanca, Morocco
| | - Aya Kanas
- Mohamed VI Oncology Center, Casablanca, Morocco; Faculty of Medicine and Pharmacy, University Hassan II, Ain chock BP 5366, 20000 Casablanca, Morocco
| | - Mustapha Benhessou
- Mohamed VI Oncology Center, Casablanca, Morocco; Faculty of Medicine and Pharmacy, University Hassan II, Ain chock BP 5366, 20000 Casablanca, Morocco
| | - Mohammed Ennachit
- Mohamed VI Oncology Center, Casablanca, Morocco; Faculty of Medicine and Pharmacy, University Hassan II, Ain chock BP 5366, 20000 Casablanca, Morocco
| | - Mohammed El Kerrroumi
- Mohamed VI Oncology Center, Casablanca, Morocco; Faculty of Medicine and Pharmacy, University Hassan II, Ain chock BP 5366, 20000 Casablanca, Morocco
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6
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Zheng Y, Wang H, Li Q, Sun H, Guo L. Discriminating Between Benign and Malignant Solid Ovarian Tumors Based on Clinical and Radiomic Features of MRI. Acad Radiol 2022; 30:814-822. [PMID: 35810066 DOI: 10.1016/j.acra.2022.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 05/31/2022] [Accepted: 06/08/2022] [Indexed: 12/17/2022]
Abstract
RATIONALE AND OBJECTIVES To develop and validate a combined model integrating clinical and radiomic features to non-invasive discriminate between the benign and malignant solid ovarian tumors. MATERIALS AND METHODS A total of 148 patients with 156 solid ovarian tumors (86 benign and 70 malignant tumors) were included in this study. The dataset was split into the training and the test set with a ratio of 8:2 using stratified random sampling. 12 clinical features and 1612 radiomic features were extracted from each tumor. These features were selected by least absolute shrinkage and selection operator (Lasso). Three classification models were built using extreme gradient boosting (XGB) algorithm: clinical model, radiomic model, combined model. The area under the receiver operating characteristic curve (AUC), accuracy, precision and sensitivity were analyzed to evaluate the performance of these models. RESULTS All of the three models obtained good performances in differentiating benign with malignant solid ovarian tumors in both training and test sets. The AUC, accuracy, precision, sensitivity of clinical model and radiomic model in test set were 0.847 (95% confidence interval (CI), 0.707-0.986, p <0.01), 0.774, 0.769, 0.714, and 0.807 (95%CI, 0.652-0.961, p <0.05), 0.677, 0.643, 0.643, respectively. Combined model had the best prediction results, the AUC, accuracy, precision and sensitivity were 0.954 (95%CI, 0.862-1.0, p <0.01), 0.839, 0.909 and 0.714 in test set. CONCLUSION Radiomics based on machine learning can be helpful for radiologists in differentiating the benign and malignant solid ovarian tumors.
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Affiliation(s)
- Yuemei Zheng
- School of Medical Imaging, Tianjin Medical University, No. 1 Guangdong Road, Tianjin 300203, China
| | - Hong Wang
- Department of Radiology, Tianjin First Central Hospital, Tianjin, China
| | - Qiong Li
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Haoran Sun
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Guo
- School of Medical Imaging, Tianjin Medical University, No. 1 Guangdong Road, Tianjin 300203, China.
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7
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Mi D, Zhang Y, Chen S. HE4 is associated with clinical risk prognostic factors and survival outcome in primary fallopian tube carcinoma patients. J Obstet Gynaecol Res 2022; 48:1897-1903. [PMID: 35596602 DOI: 10.1111/jog.15293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 03/20/2022] [Accepted: 05/07/2022] [Indexed: 12/01/2022]
Abstract
AIM To explore whether HE4 was associated with clinical risk prognostic factors and survival outcome in primary fallopian tube carcinoma patients. METHODS Ninety-six primary fallopian tube carcinoma (PFTC) patients from March 2011 to June 2019 were enrolled in this study. Serum CA125 and HE4 concentrations were measured at four time points including primary diagnosis, postsurgery, pre-recurrence, and recurrence. The relations between clinical risk prognostic factors with HE4 concentrations were investigated, and multivariate survival analysis was used to calculate the hazard ratios between HE4 levels with recurrence-free survival and overall survival. RESULTS HE4 were significantly elevated in poor performance status, advanced stage, high histological grade and residual tumor diameter >1 cm, and positive lymph node status, respectively, compared with those in well performance status, early stage, low histological grade, residual tumor diameter ≤1 cm, and negative lymph node status, respectively. Multivariate survival analysis indicated serum HE4 can predict outcome of recurrence-free survival and overall survival with hazard ratios of 9.92 (95% confidence interval [CI]: 2.95-33.32) and 3.12 (95% CI: 1.07-9.08), respectively. CONCLUSION HE4 is associated with clinical risk prognostic factors in PFTC and contributes to predict survival outcome in PFTC cases.
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Affiliation(s)
- Dong Mi
- Department of Clinical Laboratory, Tianjin Central Hospital of Obstetrics and Gynecology, Affiliated Maternity Hospital of Nankai University, Tianjin, China
| | - Yuexiang Zhang
- Department of Clinical Laboratory, Tianjin Central Hospital of Obstetrics and Gynecology, Affiliated Maternity Hospital of Nankai University, Tianjin, China
| | - Shuqin Chen
- Department of Clinical Laboratory, Tianjin Central Hospital of Obstetrics and Gynecology, Affiliated Maternity Hospital of Nankai University, Tianjin, China
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8
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Thanasa E, Stamouli D, Gerokostas EE, Balafa K, Koutalia N, Thanasas I. Primary Fallopian Tube Carcinoma: An Extremely Rare Gynecological Cancer Misdiagnosed Intraoperatively as Benign Ovarian Neoplasm: A Case Report. Clin Pract 2022; 12:253-260. [PMID: 35645307 PMCID: PMC9150006 DOI: 10.3390/clinpract12030030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 04/11/2022] [Accepted: 04/17/2022] [Indexed: 02/04/2023] Open
Abstract
Primary fallopian tube carcinoma is very rare. Diagnosis is challenging. The description of our case concerns an asymptomatic 71-year-old patient who came for a routine gynecological examination. Imaging of the pelvis revealed the presence of a two-chambered cystic formation in the anatomical position of the right ovary. It was decided to investigate the disease by laparotomy. Examination of the frozen section from the site of the cystic lesion was negative for malignancy. An abdominal total hysterectomy was performed with bilateral salpingo-oophorectomy. Serous carcinoma of the fallopian tube was diagnosed postoperatively by histological examination of the surgical preparation. Immediately after surgery, the patient’s health was good.The patient was referred to an oncology center and was monitored. Chemotherapy based on platinum and taxane was recommended. Six months after the operation the patient is in good health. The possibility of a second surgery to treat fallopian tube cancer with pelvic lymph node dissectionis under discussion and is expected to be decided by oncologists and gynecologists-oncologists. In this article, after describing the case report, a brief review of this rare entity disease’s diagnostic and therapeutic approach is attempted.
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Affiliation(s)
- Efthymia Thanasa
- Department of Health Sciences, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Dimitra Stamouli
- Department of Obstetrics and Gynecology, General Hospital in Trikala, Efkli 33, 42100 Trikala, Greece; (D.S.); (E.-E.G.); (K.B.); (N.K.)
| | - Ektoras-Evangelos Gerokostas
- Department of Obstetrics and Gynecology, General Hospital in Trikala, Efkli 33, 42100 Trikala, Greece; (D.S.); (E.-E.G.); (K.B.); (N.K.)
| | - Konstantina Balafa
- Department of Obstetrics and Gynecology, General Hospital in Trikala, Efkli 33, 42100 Trikala, Greece; (D.S.); (E.-E.G.); (K.B.); (N.K.)
| | - Nikoleta Koutalia
- Department of Obstetrics and Gynecology, General Hospital in Trikala, Efkli 33, 42100 Trikala, Greece; (D.S.); (E.-E.G.); (K.B.); (N.K.)
| | - Ioannis Thanasas
- Department of Obstetrics and Gynecology, General Hospital in Trikala, Efkli 33, 42100 Trikala, Greece; (D.S.); (E.-E.G.); (K.B.); (N.K.)
- Correspondence: ; Tel.: +30-2431029103 or +30-6944766469
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9
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Kinson MS, Rush DS, Santamaria Flores E, Cardenas-Goicoechea SJ, Moawad NS. Occult Synchronous Bilateral Fallopian Tube Cancers: Hysterectomy and Bilateral Salpingectomy for a Benign Indication. J Gynecol Surg 2022. [DOI: 10.1089/gyn.2021.0135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Michael S. Kinson
- Department of Obstetrics & Gynecology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Demaretta S. Rush
- Department of Pathology, University of Arizona College of Medicine, Tucson, Arizona, USA
| | - Estefania Santamaria Flores
- Department of Obstetrics & Gynecology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Segundo Joel Cardenas-Goicoechea
- Division of Gynecologic Oncology and University of Florida, Gainesville, Florida, USA
- Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Nash S. Moawad
- Division of Minimally-Invasive Gynecologic Surgery, University of Florida, Gainesville, Florida, USA
- Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville, Florida, USA
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10
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Hundal J, Lopetegui-Lia N, Rabitaille W. Fallopian tube cancer- challenging to diagnose but not as infrequent as originally thought. J Community Hosp Intern Med Perspect 2021; 11:393-396. [PMID: 34234914 PMCID: PMC8118448 DOI: 10.1080/20009666.2021.1893889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Background: Primary fallopian tube carcinoma (PFTC) is a rare gynecological malignancy though its prevalence may be underestimated given that most ‘ovarian’ serous cancers originate in the fallopian tube. Its diagnosis is challenging due to its vague signs and symptoms on presentation and it is frequently under-diagnosed pre-operatively. Case Presentation: We present a case of a pre-menopausal woman who presented with vaginal bleeding. Her laboratory testing and physical examination were grossly unremarkable. Gynecologic ultrasound demonstrated multiple uterine fibroids and a double layer endometrium measuring 4.5 mm. More importantly, the left ovary was seen with a complex cyst with mildly echogenic fluid and a solid excerscence. These findings were suspicious for malignancy. The clinical and radiological findings with elevated CA-125 were consistent with a malignant process. Patient subsequently underwent a diagnostic laparoscopy, which required conversion to exploratory laparotomy, supracervical hysterectomy, bilateral salpingo-oophorectomy, right ureteral lysis, right para-aortic and right pelvic lymph node debulking and omentectomy. Biopsy of left fallopian tube and ovary revealed invasive high-grade serous carcinoma of fallopian tube, with involvement of lymphovascular spaces and with surface involvement. Peritoneal washings were negative for malignancy. She was diagnosed with a high-grade serous carcinoma of the fallopian tube after undergoing an endometrial biopsy, multiple imaging tests and finally surgical intervention that yielded the diagnosis. She was started on chemotherapy with carboplatin and paclitaxel. Conclusion: Our aim is to highlight the importance of having PFTC among the differential diagnosis when women present with vaginal bleeding or abdominal pain, as the clinical presentation of PFTC tends to be non-specific, and is often under-diagnosed; reviewing the diagnosis and management, and characterizing the similarities and differences of PFTC with other gynecological malignancies such as ovarian cancer.
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Affiliation(s)
- Jasmin Hundal
- Department of Medicine, University of Connecticut Health Center, Trinity Health of New England - Saint Francis Hospital, Hartford, USA
| | - Nerea Lopetegui-Lia
- Department of Medicine, University of Connecticut Health Center, Trinity Health of New England - Saint Francis Hospital, Hartford, USA
| | - William Rabitaille
- Department of Medicine, University of Connecticut Health Center, Trinity Health of New England - Saint Francis Hospital, Hartford, USA
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11
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Li C, Li J, Huang Q, Feng X, Zhao F, Xu F, Han D, Lyu J. Developing and validating a novel nomogram used a competing-risks model for predicting the prognosis of primary fallopian tube carcinoma: a retrospective study based on the SEER database. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:378. [PMID: 33842599 PMCID: PMC8033332 DOI: 10.21037/atm-20-5398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background The current prognostic methods for primary fallopian tube carcinoma (PFTC) are inadequate. This study is the first to use a competing-risks model to perform an accurate analysis of the prognostic factors for PFTC cause-specific death (CSD). We used the model to established a nomogram for the 3-, 5-, and 8-year CSD rates based on the identified prognostic factors. Methods This study selected 1,924 patients from the SEER (Surveillance, Epidemiology, and End Results) database. The cumulative incidence function (CIF) was used in univariate analyses, and Gray’s test was used to determine the intergroup difference in the CIF. We then used the subdistribution proportional hazards model in a multivariate analysis. We finally used the prognostic factors identified in the analysis of the competing-risks model to construct a 3-, 5-, and 8-year CSD nomogram for PFTC patients. The concordance index (C-index) and calibration plots were used to evaluate the discrimination ability and consistency of the model. Results The subdistribution proportional hazards model showed that age, histological type, FIGO stage, and the log of the ratio between the numbers of positive and negative lymph nodes (LODDS) were independent prognostic factors for CSD. The 3-, 5-, and 8-year C-indexes were 0.744, 0.744, and 0.733 in the training cohort, and 0.737, 0.748, and 0.721 in the validation cohort. In the calibration plots, the forecast lines were very close to the reference lines. Conclusions This study is the first to analyze the prognostic factors for PFTC based on a competing-risks model. This model indicates that age, histological type, FIGO stage, and LODDS are significant prognostic factors affecting CSD in PFTC patients. We have also constructed the first 3-, 5-, and 8-year CSD nomogram for PFTC patients. This nomogram exhibits good discrimination ability and accuracy and can help clinicians to provide individualized prognostic analysis for PFTC patients.
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Affiliation(s)
- Chengzhuo Li
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Junyuan Li
- Medical Centre of Stomatology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Qiao Huang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xiaojie Feng
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Fanfan Zhao
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Fengshuo Xu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Didi Han
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
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12
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Gupta AK, Vazquez OA. Fallopian Tube Tumor Mimicking Primary Gastrointestinal Malignancy. Cureus 2020; 12:e9795. [PMID: 32953309 PMCID: PMC7494413 DOI: 10.7759/cureus.9795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 67-year-old female patient positive for a mismatch repair gene mutation and history of serous carcinoma of the fallopian tube presented with a lower gastrointestinal bleed. Clinical workup was suggestive of a primary gastrointestinal malignancy. Pathological review after right hemicolectomy revealed the primary tumor was a fallopian tube carcinoma. Over the next few years, she presented with upper and lower gastrointestinal bleeds from a recurrent metastatic disease, which was from the primary fallopian tube cancer. Although serous carcinoma of the fallopian tube is not an uncommon diagnosis, it is unusual for it to present with symptoms of recurrent gastrointestinal bleed mimicking a primary gastrointestinal malignancy.
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Affiliation(s)
- Anupam K Gupta
- Minimally Invasive Surgery, University of Miami Hospital, Miami, USA
| | - Oscar A Vazquez
- Surgery, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, USA
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13
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Jiang J, Chen ZP, Zhu HP, Zhang YQ, Qian XL, Zhang M, Ni C, Zuo Y. Responses of metastatic primary fallopian tube carcinoma to pembrolizumab and nab-paclitaxel: A case report. Medicine (Baltimore) 2020; 99:e21203. [PMID: 32664168 PMCID: PMC7360280 DOI: 10.1097/md.0000000000021203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Primary fallopian tube carcinoma (PFTC) is an extremely rare but invasive malignancy with a dismal prognosis. Very few data exist on the salvage treatment for patients with PFTC. Here we report a case showing an impressive response to immunotherapy combined with chemotherapy, which have never been reported before on patients with metastatic PFTC. PATIENT CONCERNS A 42-year-old woman, who was diagnosed with PFTC in 2010, had been failed of multiple systemic therapies and antiangiogenic therapy because of the disease recurrence and progression. DIAGNOSIS Metastatic primary fallopian tube carcinoma. INTERVENTIONS The patient underwent surgery in May 2010 and had multi-line chemotherapies plus an anti-vascular endothelial growth factor (anti-VEGF) monoclonal antibody for about 9 years. Due to treatment failure the patient accepted the immunotherapy with the checkpoint inhibitor, pembrolizumab, combined with nab-paclitaxel from December 2018 to April 2019. OUTCOMES The patient showed a complete response after 6 cycles treatment. Thus far, the patient is taking pembrolizumab as maintenance and remains in good health. LESSONS Pembrolizumab combined with chemotherapy for treatment of PFTC may provide a positive antitumor effect in multiple metastatic lesions, but more clinical evidence is needed to confirm the efficacy and safety.
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Yang Y, Xiao Z, Liu Z, Lv F. MRI can be used to differentiate between primary fallopian tube carcinoma and epithelial ovarian cancer. Clin Radiol 2020; 75:457-465. [DOI: 10.1016/j.crad.2020.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 02/03/2020] [Indexed: 12/30/2022]
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Lee DH, Cho DH, Kim KM, Yim CY, Lee NR. Primary transitional cell carcinoma of the fallopian tube: A case report and literature review. Medicine (Baltimore) 2020; 99:e20499. [PMID: 32481467 DOI: 10.1097/md.0000000000020499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Primary transitional cell carcinoma (TCC) of the fallopian tube is an extremely rare tumor. PATIENT CONCERNS A 79-year-old woman presenting with vaginal discharge. DIAGNOSIS Pelvic magnetic resonance imaging revealed a predominantly solid mass with a lobulated contour, measuring 5.5 cm × 4.6 cm, in the left ovary. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. Pathological analysis revealed a high-grade TCC, measuring 7.5 cm × 4 cm, in the left fallopian tube (International Federation of Gynecology and Obstetrics stage IIB). INTERVENTION Forty-three months postoperation, recurrence was diagnosed as peritoneal metastasis. The patient underwent 6 cycles of palliative chemotherapy consisting of cisplatin and gemcitabine, the recommended regimen for TCC of the urinary tract. OUTCOME The patient has survived for 27 months without recurrence after palliative chemotherapy, 76 months after diagnosis. CONCLUSION It is rare that primary TCC of the fallopian tube responds to a urinary tract treatment regimen for TCC, even when followed up for an extended period. More research is warranted to determine which treatment regimen will benefit patients the most.
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Affiliation(s)
- Dong-Hyun Lee
- Department of Obstetrics and Gynecology, Jeonbuk National University Hospital-Jeonbuk National University Medical School
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital
| | - Dong-Hyu Cho
- Department of Obstetrics and Gynecology, Jeonbuk National University Hospital-Jeonbuk National University Medical School
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital
| | - Kyoung Min Kim
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital
- Department of Pathology
| | - Chang-Yeol Yim
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital
- Division of Hematology and oncology, Department of Internal Medicine, Jeonbuk National University Hospital-Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Na-Ri Lee
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital
- Division of Hematology and oncology, Department of Internal Medicine, Jeonbuk National University Hospital-Jeonbuk National University Medical School, Jeonju, Republic of Korea
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Sun M, Bao L, Shen H, Ji M, Yao L, Yi X, Jiang W. Unexpected primary fallopian tube carcinoma during gynecological operations: Clinicopathological and prognostic factors analyses of 67 cases. Taiwan J Obstet Gynecol 2019; 58:626-632. [DOI: 10.1016/j.tjog.2019.07.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2019] [Indexed: 12/27/2022] Open
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Abstract
Once a pelvic mass is identified on an ultrasound examination, the first step in the differential diagnostic work up is to determine its origin. Most lateral pelvic masses in women are ovarian in origin, and the distinction between ovarian and nonovarian mimics of ovarian cancer is critical for appropriate clinical and surgical management. Adnexal masses detected on ultrasound can be further characterized by magnetic resonance imaging (MRI) when needed. Superior contrast resolution, multiplanar imaging, characteristic signal intensity of common pathology such as dermoid tumors or endometriomas allows one to accurately evaluate adnexal tumors with supplemental use of MRI. Commonly encountered extraovarian abnormalities that mimic ovarian malignancies are categorized as being either predominantly cystic or solid. The common causes of such extraovarian lesions that mimic ovarian pathology include fallopian tube diseases, paroaovarian cysts, peritoneal inclusion cysts, and a pedunculated or a broad ligament fibroid. Less common causes of cystic and solid nonovarian mimics of ovarian malignancy include mucocele of the appendix, lymphocele, spinal meningeal cysts, extraovarian endometriomas, extraovarian fibrothecomas, and gastrointestinal stromal tumors (Table 1). Identifying a normal appearing ovary is the key in distinguishing an extraovarian pelvic mass from an ovarian tumor. This becomes particularly challenging in postmenopausal women with atrophic ovaries. In this scenario, MRI comes into use by identifying small atrophic ovaries more often than ultrasound is able to. Extraovarian lesions typically displace the pelvic sidewall vasculature medially, ureters tend to be compressed, encased or medially displaced, enhancement matches pelvic arteries and may be associated with engorged mesenteric vessels compared to gonadal vessel engorgement seen with ovarian tumors.
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Hyriavenko N, Lyndin M, Sikora K, Piddubnyi A, Karpenko L, Kravtsova O, Hyriavenko D, Diachenko O, Sikora V, Romaniuk A. Serous Adenocarcinoma of Fallopian Tubes: Histological and Immunohistochemical Aspects. J Pathol Transl Med 2019; 53:236-243. [PMID: 30971070 PMCID: PMC6639703 DOI: 10.4132/jptm.2019.03.21] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 03/20/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Although primary cancer of the fallopian tubes is a relatively rare type of tumor in female reproductive organs, its mortality is quite high. It is important to identify molecular and biological markers of this malignancy that determine its specific phenotype. METHODS The study was carried out on samples received from 71 female patients with primary cancer of the fallopian tubes. The main molecular and biological properties, including hormone status (estrogen receptor [ER], progesterone receptor [PR]), human epidermal growth factor receptor (HER2)/neu expression, proliferative potential (Ki-67), apoptosis (p53, Bcl-2), and pro-angiogenic (vascular endothelial growth factor) quality of serous tumors were studied in comparison with clinical and morphological characteristics. RESULTS ER and PR expression is accompanied by low grade neoplasia, early clinical disease stage, and absence of lymphogenic metastasis (p < .001). HER2/neu expression is not typical for primary cancer of the fallopian tubes. Ki-67 expression is characterized by an inverse correlation with ER and PR (p < .05) and is associated with lymphogenic metastasis (p < .01). p53+ status correlates with high grade malignancy, tumor progression, metastasis, negative ER/PR (p < .001), and negative Bcl-2 status (p < .05). Positive Bcl-2 status is positively correlated with ER and PR expression and low grade malignancy. CONCLUSIONS Complex morphologic (histological and immunohistochemical) study of postoperative material allows estimation of the degree of malignancy and tumor spread to enable appropriate treatment for each case.
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Affiliation(s)
| | - Mykola Lyndin
- Department of Pathology, Sumy State University, Sumy, Ukraine
| | | | - Artem Piddubnyi
- Department of Pathology, Sumy State University, Sumy, Ukraine
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Laban M, Ibrahim EA, Hassanin AS, Nasreldin MA, Mansour A, Khalaf WM, Bahaa Eldin AM, Hussain SH, Elsafty MS, Hasanien AS. Chlamydia trachomatis infection in primary fallopian tube and high-grade serous ovarian cancers: a pilot study. Int J Womens Health 2019; 11:199-205. [PMID: 30962726 PMCID: PMC6434919 DOI: 10.2147/ijwh.s188938] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background The aim of this study was to evaluate the association of Chlamydia trachomatis (CT) infection with primary tubal and high-grade serous ovarian cancers. Methods This is a cross-sectional, retrospective study conducted at Ain Shams University Maternity Hospital, Egypt, from February 2008 to October 2017. Sixty-seven paraffin archival blocks specimens were retrieved from cases who underwent staging laparotomy due to high-grade serous ovarian cancer (30 cases), primary tubal serous cancer (25 cases), and control specimens of (12) tubal specimens from cases of benign gynecological conditions. All samples were examined for CT DNA using semiquantitative qRT-PCR. Results CT DNA was detected in 84% of high-grade tubal serous cancer, 16.7% of high-grade serous ovarian cancer, and 13.3% in controls (P<0.0005). Mean CT DNA relative quantity was significantly high (256) in tubal carcinoma, in comparison to that in high-grade serous ovarian cancer and controls (13.5 and 0.28, respectively; P<0.0005). Conclusion To the best of our knowledge, this is the first report on relation of CT to the tubal serous cancer, so the responsibility of CT tubal infection in the pathogenesis of primary tubal cancer needs to be considered.
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Affiliation(s)
- Mohamed Laban
- Gynecologic Oncology Unit, Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Eman A Ibrahim
- Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Alaa S Hassanin
- Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt,
| | - Magda A Nasreldin
- Pathology Department, Early Cancer Detection Unit of Ain Shams Maternity Hospital, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Amal Mansour
- Biochemistry and Molecular Biology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Waleed M Khalaf
- Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt,
| | - Ahmed M Bahaa Eldin
- Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt,
| | - Sherif H Hussain
- Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt,
| | - Mohammed S Elsafty
- Gynecologic Oncology Unit, Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ahmad S Hasanien
- Family Medicine Department, Royal Australian College of General Practitioners, Sydney, Australia
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de la Chica Rubio V, Vázquez Valeo C, Rodríguez Zarco E, Cabezas Palacios M. Metástasis de adenocarcinoma de colon en trompa de Falopio. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2018. [DOI: 10.1016/j.gine.2017.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Prognostic factors of primary fallopian tube carcinoma. Contemp Oncol (Pozn) 2018; 22:99-104. [PMID: 30150886 PMCID: PMC6103229 DOI: 10.5114/wo.2017.69590] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 05/07/2017] [Indexed: 11/23/2022] Open
Abstract
Aim of the study Fallopian tube cancer is very rare in the literature and so there are not enough data about the therapeutic approaches. The approaches are generally determined in accordance with the data obtained from ovarian cancer. Many prognostic factors have been investigated in an effort to better estimate patient outcome. Stage, age, and residual tumor after surgery are consistently important prognostic factors. In this study, we aimed to evaluate the prognostic factors and survival rates of primary fallopian tube cancer (PFTC), which is rare among gynecological cancers. Material and methods Thirty-eight patients with a diagnosis of PFTC were identified through the gynecologic oncology service database of our Research and Training Hospital in the period 1995–2013. Clinicopathological and surgical data were collected. All patients were evaluated for survival and disease-free survival between the dates specified. Results A significant relationship and correlation was found between optimal surgery and life expectancy. Better results were obtained in patients treated with optimal surgery. The survival probability was found to be higher in patients with lower CA-125 levels and serous histologic type adenocarcinoma. Conclusions Stage is one of the factors affecting the survival probability. We determined that the pathological type of tumor, the diameter of residual tumor remaining after surgery, tumor grade, preoperative CA-125 levels and presence of ascites affect the survival probability.
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Successful diagnosis of an occult fallopian tube carcinoma detected from the diaphragm metastasis. Gen Thorac Cardiovasc Surg 2018; 66:484-487. [PMID: 29327265 DOI: 10.1007/s11748-017-0881-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 12/26/2017] [Indexed: 10/18/2022]
Abstract
We herein reported a rare case of an occult fallopian tube carcinoma first detected from the diaphragm metastasis. An 83-year-old woman who had a 30-mm tumor on the right diaphragm underwent radical resection. Pathologically, the tumor was diagnosed as a high-grade serous adenocarcinoma, suggesting metastasis from the pelvic visceral carcinoma. Although the primary site could not be detected by imaging examinations, laparoscopy revealed multiple peritoneal disseminations; therefore, total hysterectomy was performed. Finally, microscopic tumor invasion into the right fimbriae of the fallopian tube was found. A precise and detailed pathological and immunohistochemical examinations of the resected metastatic diaphragm tumor helped us obtain a proper diagnosis of the primary lesion and treat the patient appropriately. Since it is difficult to diagnose diaphragm tumors before surgery based on the anatomy, surgical options have played an important role in their treatment and diagnosis clinically.
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Rexhepi M, Trajkovska E, Ismaili H, Besimi F, Rufati N. Primary Fallopian Tube Carcinoma: A Case Report and Literature Review. Open Access Maced J Med Sci 2017; 5:344-348. [PMID: 28698755 PMCID: PMC5503735 DOI: 10.3889/oamjms.2017.044] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 03/16/2017] [Accepted: 03/17/2017] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Primary fallopian tube carcinoma (PFTC) is a rare tumour of the female genital tract with an incidence of 0.1-1.8% of all genital malignancies, and it is very difficult to diagnose preoperatively, because of its non-specific symptomatology. In most cases, it is an intraoperative finding or a histopathological diagnosis. It is a tumour that histologically and clinically resembles epithelial ovarian cancer. CASE PRESENTATION We are reporting a case of a 62-year-old, postmenopausal women with primary fallopian tube carcinoma of the right fallopian tube in stage IA. The patient has lower abdominal pain, watery vaginal discharge and repeated episodes of bleeding from the vagina. The clinical and radiological findings suggested a right adnexal tumour with elevated CA-125 levels. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy and peritoneal washing were performed. Pathologic confirmation of primary serous cystadenocarcinoma of the right fallopian tube was made. Peritoneal washings were negative for malignancy. FIGO stage was considered as IA, and the patient received no courses of chemotherapy and postoperative radiation because she refused it. Ten months after initial surgery, the patient is alive and in good condition. CONCLUSION Cytoreduction surgery followed by adequate cycles of chemotherapy is an important strategy to improve patients' prognosis.
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Affiliation(s)
- Meral Rexhepi
- Clinical Hospital Tetovo, Department of Gynecology and Obstetrics, University of Tetovo, Faculty of Medical Sciences, Tetovo, Republic of Macedonia
| | - Elizabeta Trajkovska
- Clinical Hospital Tetovo, Department of Pathology, Tetovo, Republic of Macedonia
| | - Hysni Ismaili
- University of Tetovo, Faculty of Medical Sciences, Tetovo, Republic of Macedonia
| | - Florin Besimi
- Clinical Hospital Tetovo, Department of Gynecology and Obstetrics, University of Tetovo, Faculty of Medical Sciences, Tetovo, Republic of Macedonia
| | - Nagip Rufati
- Clinical Hospital Tetovo, Department of Gynecology and Obstetrics, University of Tetovo, Faculty of Medical Sciences, Tetovo, Republic of Macedonia
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Primary Fallopian Tube Carcinoma: A Single-Institution Experience of 101 Cases: A Retrospective Study. Int J Gynecol Cancer 2016; 26:424-30. [PMID: 26825825 DOI: 10.1097/igc.0000000000000648] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE This study aimed to identify the prognostic factors for primary fallopian tube carcinoma. METHODS A retrospective analysis was conducted of the patients treated with primary surgery and adjuvant chemotherapy at the Obstetrics and Gynecology Hospital of Fudan University from February 2003 to December 2010. Cox proportional hazards model was used for univariate and multivariate survival analysis. RESULTS Included in this study were 101 patients with a median follow-up of 64 months and a mean age of 57 years. Latzko triad symptom of abdominal pain, vaginal bleeding or discharge, and palpable pelvic mass was reported in 14 patients, and elevated CA 125 (≥ 35 U/mL) was found in 63. Four patients were classified as grade 1, 31 were grade 2, and 66 were grade 3. The distribution of International Federation of Gynecology and Obstetrics stage was 33 at stage I, 28 at stage II, 39 at stage III, and 1 at stage IV. Ninety patients underwent optimal tumor debulking in which residual tumor was no larger than 1 cm, and 67 patients received no fewer than 6 cycles of postoperative chemotherapy with paclitaxel and carboplatin (TP)-based regimen. Recurrence occurred in 44 patients after a median of 20 months (range, 1-72 months). The 5-year overall survival rate was 67.7%, and the 5-year disease-free survival was 57.4%. Multivariate analysis revealed that International Federation of Gynecology and Obstetrics stage (I-II) [hazard ratio (HR), 2.670; 95% confidence interval (CI), 1.316-5.418; P = 0.007 vs HR, 2.716; 95% CI, 1.416-5.211; P = 0.003], pelvic lymphadenectomy (HR, 0.274; 95% CI, 0.136-0.555; P < 0.001 vs HR, 0.449; 95% CI, 0.227-0.888; P = 0.021), and cycles (≥ 6) of chemotherapy (HR, 0.480; 95% CI, 0.246-0.937; P = 0.031 vs HR, 0.521; 95% CI, 0.276-0.985; P = 0.045) might serve as independent predictors of both overall survival and disease-free survival. CONCLUSIONS Preoperative diagnosis of fallopian tube carcinoma is difficult due to the silent course of this neoplasm. Comprehensive surgical staging including pelvic lymphadenectomy followed by adequate cycles of chemotherapy is an important strategy to improve patients' prognosis.
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Fallopian tube cancer incidentally diagnosed during laparoscopy for metastatic adenocarcinoma of unknown primary lesion. Gynecol Minim Invasive Ther 2016. [DOI: 10.1016/j.gmit.2015.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Soini T, Hurskainen R, Grénman S, Mäenpää J, Paavonen J, Pukkala E. Impact of levonorgestrel-releasing intrauterine system use on the cancer risk of the ovary and fallopian tube. Acta Oncol 2016; 55:1281-1284. [PMID: 27148621 DOI: 10.1080/0284186x.2016.1175660] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Levonorgestrel-releasing intrauterine system (LNG-IUS) is used for contraception and heavy menstrual bleeding. A long-term hormone therapy can modify the risk of gynecologic cancers. Little is known about the impact of LNG-IUS use on the risk for invasive and borderline ovarian tumor subtypes or for primary fallopian tube carcinoma. We examined the associations of LNG-IUS use with these tumors. MATERIAL AND METHODS We identified from the national Medical Reimbursement Registry of Finland the women aged 30-49 years who had used LNG-IUS for menorrhagia in 1994-2007, and from the Finnish Cancer Registry ovarian cancers and primary fallopian tube carcinomas diagnosed before the age of 55 and by the end of 2013. RESULTS A total of 77 invasive ovarian cancers and seven primary fallopian tube carcinoma cases were diagnosed in a cohort of 93 843 LNG-IUS users during the follow-up of 1 083 126 women-years. The LNG-IUS users had decreased risk for both invasive ovarian cancer [standardized incidence ratio (SIR) 0.59, 95% confidence interval (CI) 0.47-0.73] and for borderline ovarian tumors (SIR 0.76, 95% CI 0.57-0.99) as compared to the background population. The risk of primary fallopian tube carcinoma was not increased (SIR 1.22, 95% CI 0.49-2.50). Decreased risks for mucinous (SIR 0.49, 95% CI 0.24-0.87), endometrioid (SIR 0.55, 95% CI 0.28-0.98), and serous ovarian carcinomas (SIR 0.75, 95% CI 0.55-0.99) were seen in LNG-IUS users. CONCLUSIONS LNG-IUS use associated with decreased risk for both invasive and borderline ovarian tumors. The incidence of primary fallopian tube carcinoma did not significantly differ between LNG-IUS users and the background population.
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Affiliation(s)
- Tuuli Soini
- Department of Obstetrics and Gynecology, Hyvinkää Hospital, Hyvinkää, Finland
| | - Ritva Hurskainen
- Department of Obstetrics and Gynecology, Hyvinkää Hospital, Hyvinkää, Finland
| | - Seija Grénman
- Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland
- University of Turku, Turku, Finland
| | - Johanna Mäenpää
- School of Medicine, University of Tampere, University of Tampere, Finland
- Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland
| | - Jorma Paavonen
- Department of Obstetrics and Gynecology, Helsinki University Hospital, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
| | - Eero Pukkala
- School of Health Sciences, University of Tampere, University of Tampere, Tampere, Finland
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
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Gottschau M, Mellemkjaer L, Hannibal CG, Kjaer SK. Ovarian and tubal cancer in Denmark: an update on incidence and survival. Acta Obstet Gynecol Scand 2016; 95:1181-9. [DOI: 10.1111/aogs.12948] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 07/02/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Mathilde Gottschau
- Virus, Lifestyle and Genes; Danish Cancer Society Research Center; Copenhagen Denmark
| | - Lene Mellemkjaer
- Virus, Lifestyle and Genes; Danish Cancer Society Research Center; Copenhagen Denmark
| | - Charlotte G. Hannibal
- Virus, Lifestyle and Genes; Danish Cancer Society Research Center; Copenhagen Denmark
| | - Susanne K. Kjaer
- Virus, Lifestyle and Genes; Danish Cancer Society Research Center; Copenhagen Denmark
- Department of Gynecology; Rigshospitalet; University of Copenhagen; Copenhagen Denmark
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Mi D, Zhang YX, Wang CJ, Feng Q, Qi P, Chen SQ. Diagnostic and prognostic value of serum human epididymis protein 4 in patients with primary fallopian tube carcinoma. J Obstet Gynaecol Res 2016; 42:1326-1335. [PMID: 27307153 DOI: 10.1111/jog.13053] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 04/09/2016] [Indexed: 01/01/2023]
Abstract
AIM The aim of our study was to assess the levels of human epididymis protein 4 (HE4) with the common tumor marker carbohydrate antigen 125 (CA125) in the diagnosis and monitoring of therapy for primary fallopian tube carcinoma (PFTC). METHODS Serum HE4 and CA125 levels from 82 PFTC patients and 154 patients with benign pelvic masses as the control were measured by Roche electrochemiluminescent immunoassay. HE4 determinations for surgery response and recurrence monitoring were assessed in PFTC patients. RESULTS Serum HE4 and CA125 concentrations were significantly higher in PFTC patients compared with those seen in patients with benign pelvic masses (P < 0.001). Compared with CA125, HE4 had higher specificity, but lower sensitivity whether at early or advanced stage, and the combination of HE4 + CA125 led to higher sensitivity and specificity. HE4 + CA125 performed significantly better than CA125 or HE4 alone in early stage patients. In early stage the sensitivity was 35.7% for HE4 and 64.3% for CA125, while sensitivity for the combination of HE4 and CA125 could reach 71.4%. Furthermore, the two markers were associated with the progression and histology of PFTC. Serum HE4 level was closely correlated with surgical therapy. PFTC patients displayed a greater decline in the level of HE4 compared with CA125 (76.4% vs 55.7%). Combined with CA125, HE4 elevation better predicted recurrence in PFTC patients. CONCLUSIONS This study indicated that serum HE4 levels are closely associated with PFTC and the outcome of surgical therapy and recurrence in Chinese patients.
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Affiliation(s)
- Dong Mi
- Department of Clinical Laboratory, Tianjin Central Hospital of Obstetrics and Gynecology, Tianjin, China.
| | - Yue-Xiang Zhang
- Department of Clinical Laboratory, Tianjin Central Hospital of Obstetrics and Gynecology, Tianjin, China
| | - Cheng-Jin Wang
- Department of Clinical Laboratory, Tianjin Central Hospital of Obstetrics and Gynecology, Tianjin, China
| | - Qiang Feng
- Department of Clinical Laboratory, Tianjin Central Hospital of Obstetrics and Gynecology, Tianjin, China
| | - Pei Qi
- Department of Clinical Laboratory, Tianjin Central Hospital of Obstetrics and Gynecology, Tianjin, China
| | - Shu-Qin Chen
- Department of Clinical Laboratory, Tianjin Central Hospital of Obstetrics and Gynecology, Tianjin, China
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Katabathina VS, Amanullah FS, Menias CO, Chen MM, Valente PT, Chintapalli KN, Prasad SR. Extrauterine Pelvic Serous Carcinomas: Current Update on Pathology and Cross-sectional Imaging Findings. Radiographics 2016; 36:918-32. [DOI: 10.1148/rg.2016150130] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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30
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Hiensch R, Meinhof K, Leytin A, Hagopian G, Szemraj E, Epelbaum O. Clinically occult primary fallopian tube carcinoma presenting as a malignant pleural effusion. CLINICAL RESPIRATORY JOURNAL 2016; 11:1086-1090. [PMID: 26646473 DOI: 10.1111/crj.12423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 09/14/2015] [Accepted: 11/13/2015] [Indexed: 11/30/2022]
Abstract
We report the first known case of malignant pleural effusion (MPE) as the sole presenting feature of clinically occult primary fallopian tube carcinoma (PFTC). A 57-year-old healthy woman was admitted with dyspnea. Evaluation demonstrated a right pleural effusion, fluid of which was malignant. The immunohistochemical profile, including negative calretinin, favored metastatic adenocarcinoma over mesothelioma but could not identify the primary tumour site. Pleural biopsy was not pursued as it would not have helped localize the primary. Chest, abdomen and pelvic computed tomography (CT) demonstrated only borderline lymphadenopathy in the left para-aortic lymph node chain that was hypermetabolic on positron emission tomography. Ultrasound and CT showed normal adnexal anatomy. These findings, coupled with an elevated serum CA-125, prompted empiric neoadjuvant chemotherapy targeting epithelial ovarian carcinoma (EOC) followed by surgery, which revealed a tiny left PFTC with negative peritoneal washings. Sampled left para-aortic lymph nodes were positive. The pleural effusion resolved after chemotherapy. Malignant pleural disease without peritoneal involvement is more characteristic of PFTC than of EOC, in which MPE is common but almost always accompanies peritoneal carcinomatosis. The extensive lymphatic supply of the fallopian tube promotes distant metastasis of small, seemingly localized tumours. This case is a reminder that the clinician should not be dissuaded from considering carcinoma of Müllerian origin, especially PFTC, as the cause of a MPE even in the face of normal gynecologic imaging. Appropriately broad immunohistochemical staining and careful attention to even minimal lymphadenopathy can be invaluable in pinpointing the primary tumour site in such patients.
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Affiliation(s)
- Robert Hiensch
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Klaus Meinhof
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Anatoly Leytin
- Department of Pathology, Elmhurst Hospital Center, Icahn School of Medicine at Mount Sinai, Queens, NY, 11373, USA
| | - George Hagopian
- Division of Gynecologic Oncology, Elmhurst Hospital Center, Icahn School of Medicine at Mount Sinai, Queens, NY, 11373, USA
| | - Eva Szemraj
- Division of Hematology and Oncology, Elmhurst Hospital Center, Icahn School of Medicine at Mount Sinai, Queens, NY, 11373, USA
| | - Oleg Epelbaum
- Division of Pulmonary and Critical Care Medicine, Elmhurst Hospital Center, Icahn School of Medicine at Mount Sinai, Queens, NY, 11373, USA
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Gurler H, Macias V, Kajdacsy-Balla AA, Barbolina MV. Examination of the Fractalkine and Fractalkine Receptor Expression in Fallopian Adenocarcinoma Reveals Differences When Compared to Ovarian Carcinoma. Biomolecules 2015; 5:3438-47. [PMID: 26633537 PMCID: PMC4693285 DOI: 10.3390/biom5043438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 11/02/2015] [Accepted: 11/30/2015] [Indexed: 12/14/2022] Open
Abstract
Fallopian adenocarcinoma is a rare malignancy arising in the epithelium of the fallopian tube. Fallopian tube epithelium has been proposed as a tissue origin for high-grade serous ovarian carcinoma, the deadliest gynecologic malignancy. Given the commonalities in dissemination and treatment of these malignancies, we contemplated the possibility of similar patterns of gene expression underlying their progression. To reveal potential similarities or differences in the gene expression of fallopian adenocarcinoma and high-grade serous ovarian carcinoma, we tested expression of the fractalkine receptor (CX3CR1) and its ligand, fractalkine (CX3CL1), in the specimens of normal and pathologic fallopian tube using immunohistochemistry. Our data show that CX3CR1 is expressed in the normal, cancer adjacent normal, inflammatory, and malignant fallopian epithelium. CX3CL1 was expressed only by the normal and cancer adjacent normal fallopian tube epithelium; its expression was largely lost in the inflammatory and malignant fallopian epithelium. In opposite, both CX3CR1 and CX3CL1 are expressed in high-grade serous ovarian carcinoma. These findings are consistent with an idea that fallopian adenocarcinoma and high-grade serous ovarian carcinoma, although currently thought to arise from the same organ, may not share similar molecular characteristics.
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Affiliation(s)
- Hilal Gurler
- Department of Biopharmaceutical Sciences, University of Illinois at Chicago, 833 South Wood Street, Chicago, IL 60612, USA.
| | - Virgilia Macias
- Department of Pathology, University of Illinois at Chicago, 840 South Wood Street, Chicago, IL 60612, USA.
| | - Andre A Kajdacsy-Balla
- Department of Pathology, University of Illinois at Chicago, 840 South Wood Street, Chicago, IL 60612, USA.
| | - Maria V Barbolina
- Department of Biopharmaceutical Sciences, University of Illinois at Chicago, 833 South Wood Street, Chicago, IL 60612, USA.
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Primary fallopian tube carcinoma: review of MR imaging findings. Insights Imaging 2015; 6:431-9. [PMID: 26150249 PMCID: PMC4519813 DOI: 10.1007/s13244-015-0416-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 05/20/2015] [Accepted: 06/15/2015] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES To review the epidemiological and clinical features of primary fallopian tube carcinoma (PFTC), and to illustrate the spectrum of MRI findings, with pathological confirmation. METHODS This article reviews the relevant literature on the epidemiological, clinical, and imaging features of primary fallopian tube carcinoma, with pathological confirmation, using illustrations from the authors' teaching files. RESULTS Primary fallopian tube carcinoma came under focus over the last few years due to its possible role on the pathogenesis of high-grade serous epithelial ovarian and peritoneal cancers. Typical symptoms, together with the presence of some of the most characteristic MRI signs, such as a "sausage-shaped" pelvic mass, hydrosalpinx, and hydrometra, may signal the presence of primary fallopian cancer, and allow the radiologist to report it as a differential diagnosis. CONCLUSIONS Primary fallopian tube carcinoma has a constellation of clinical symptoms and magnetic resonance imaging features, which may be diagnostic. Although these findings are not present together in the majority of cases, radiologists who are aware of them may include the diagnosis of primary fallopian tube cancer in their report more frequently and with more confidence. TEACHING POINTS • PFTC may be more frequent than previously thought • PFTC has specific clinical and MRI characteristics • Knowledge of typical PFTC signs enables its inclusion in the differential diagnosis • PFTC is currently staged under the 2013 FIGO system • PFTC is staged collectively with ovarian and peritoneal neoplasms.
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Eken M, Temizkan O, Kaygusuz EI, Herkiloğlu D, Çöğendez E, Karateke A. Primary carcinoma of the fallopian tubes: Analysis of sixteen patients. Turk J Obstet Gynecol 2015; 12:83-88. [PMID: 28913049 PMCID: PMC5558382 DOI: 10.4274/tjod.67355] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 05/07/2015] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE The aim of this study was to review patients with tubal carcinoma who underwent surgery in our clinic due to primary carcinoma of the fallopian tubes, a very rare gynecologic malignancy. MATERIALS AND METHODS Sixteen patients who were diagnosed as having primary carcinoma of the fallopian tubes and underwent surgery in Zeynep Kamil Research and Training Hospital between January 2007 and December 2014 were included in the study. Demographic data such as age, gravidity, parity, menopausal condition, symptoms, adjuvant therapy, recurrence of tumor, as well as time and type of operation were extracted from patient epicrisis reports and oncology files. Patient information was extracted from the patients' current files and phone calls were made with patients and their relatives. RESULTS The mean age of patients was 59.6 (range, 43-78) years. Seventy-five percent of the women were menopausal at admission; the mean menopause duration was 10 years (range, 1-20 years). None of the patients were nulliparous and mean parity was 4.3 (2-8). The most common presenting symptom was abdominopelvic pain, followed by abnormal uterine bleeding. The most common histopathologic type was high-grade serous carcinoma. The mean follow-up duration was 23.7 months (range, 2-53 months). During follow-up, recurrence was seen in 4 (25%) patients. One patient left the study during follow-up. The mean disease-free survival was 48 months. No relation was found between disease-free survival, age, stage, grade, and histologic type in univariate logistic regression analysis. CONCLUSION Primary carcinoma of the fallopian tubes is a rare gynecologic tumor that is seen in older patients, has no specific signs, and usually cannot be diagnosed before surgery. Therefore, we think that large-series, multi-centered studies with long-term follow-up duration are needed to define its etiopathogenesis and treatment strategies for the disease.
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Affiliation(s)
- Meryem Eken
- Zeynep Kamil Training and Research Hospital, Clinic of Gynecology and Obstetrics, İstanbul, Turkey
| | - Osman Temizkan
- Şişli Hamidiye Etfal Training and Research Hospital, Clinic of Gynecology and Obstetrics, İstanbul, Turkey
| | - Ecmel Işık Kaygusuz
- Zeynep Kamil Training and Research Hospital, Clinic of Pathology, İstanbul, Turkey
| | - Dilşad Herkiloğlu
- Zeynep Kamil Training and Research Hospital, Clinic of Gynecology and Obstetrics, İstanbul, Turkey
| | - Ebru Çöğendez
- Zeynep Kamil Training and Research Hospital, Clinic of Gynecology and Obstetrics, İstanbul, Turkey
| | - Ateş Karateke
- Zeynep Kamil Training and Research Hospital, Clinic of Gynecology and Obstetrics, İstanbul, Turkey
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Cobb LP, Gaillard S, Wang Y, Shih IM, Secord AA. Adenocarcinoma of Mullerian origin: review of pathogenesis, molecular biology, and emerging treatment paradigms. GYNECOLOGIC ONCOLOGY RESEARCH AND PRACTICE 2015; 2:1. [PMID: 27231561 PMCID: PMC4880836 DOI: 10.1186/s40661-015-0008-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 03/17/2015] [Indexed: 11/10/2022]
Abstract
Traditionally, epithelial ovarian, tubal, and peritoneal cancers have been viewed as separate entities with disparate origins, pathogenesis, clinical features, and outcomes. Additionally, previous classification systems for ovarian cancer have proposed two primary histologic groups that encompass the standard histologic subtypes. Recent data suggest that these groupings no longer accurately reflect our knowledge surrounding these cancers. In this review, we propose that epithelial ovarian, tubal, and peritoneal carcinomas represent a spectrum of disease that originates in the Mullerian compartment. We will discuss the incidence, classification, origin, molecular determinants, and pathologic analysis of these cancers that support the conclusion they should be collectively referred to as adenocarcinomas of Mullerian origin. As our understanding of the molecular and pathologic profiling of adenocarcinomas of Mullerian origin advances, we anticipate treatment paradigms will shift towards genomic driven therapeutic interventions.
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Affiliation(s)
- Lauren Patterson Cobb
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke Cancer Institute, Duke University Medical Center, Durham, NC 27710 USA
| | - Stephanie Gaillard
- Division of Medical Oncology, Department of Internal Medicine, Duke University Medical Center, Durham, NC 27710 USA
| | - Yihong Wang
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD 21205 USA
| | - Ie-Ming Shih
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD 21205 USA
| | - Angeles Alvarez Secord
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke Cancer Institute, Duke University Medical Center, Durham, NC 27710 USA
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McDuff SGR, Yashar CM. Radiation Therapy in Gynecologic Cancer. Gynecol Oncol 2015. [DOI: 10.1007/978-1-4939-1976-5_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Comparison of early-stage primary serous fallopian tube carcinomas and equivalent stage serous epithelial ovarian carcinomas. Taiwan J Obstet Gynecol 2014; 53:547-51. [DOI: 10.1016/j.tjog.2014.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2014] [Indexed: 11/24/2022] Open
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Gungorduk K, Ertas IE, Ozdemir A, Akkaya E, Telli E, Taskin S, Gokcu M, Guzel AB, Oge T, Akman L, Toptas T, Solmaz U, Dogan A, Terek MC, Sanci M, Ozsaran A, Simsek T, Vardar MA, Yalcin OT, Ozalp S, Yildirim Y, Ortac F. Prognostic Significance of Retroperitoneal Lymphadenectomy, Preoperative Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio in Primary Fallopian Tube Carcinoma: A Multicenter Study. Cancer Res Treat 2014; 47:480-8. [PMID: 25622588 PMCID: PMC4506112 DOI: 10.4143/crt.2014.058] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 05/01/2014] [Indexed: 12/16/2022] Open
Abstract
Purpose The purpose of this study is to evaluate the prognostic role of preoperative neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) and the need for para-aortic lymphadectomy in patients with primary fallopian tube carcinoma (PFTC). Materials and Methods Ninety-one patients with a diagnosis of PFTC were identified through the gynecologic oncology service database of six academic centers. Clinicopathological, surgical, and complete blood count data were collected. Results In univariate analysis, advanced stage, suboptimal surgery, and NLR > 2.7 were significant prognostic factors for progression-free survival, whereas in multivariate analysis, only advanced stage and suboptimal surgery were significant. In addition, in univariate analysis, cancer antigen 125 ≥ 35 U/mL, ascites, advanced stage, suboptimal surgery, NLR > 2.7, PLR > 233.3, platelet count ≥ 400,000 cells/mm3, staging type, and histological subtype were significant prognostic factors for overall survival (OS); however, in multivariate analysis, only advanced stage, suboptimal surgery, NLR > 2.7, and staging type were significant. Inclusion of pelvic and para-aortic lymphadenectomy in surgery showed significant association with longer OS, with a mean and median OS of 42.0 months and 35.5 months (range, 22 to 78 months), respectively, vs. 33.5 months and 27.5 months (range, 14 to 76 months), respectively, for patients who underwent surgery without para-aortic lymphadenectomy (hazard ratio, 3.1; 95% confidence interval, 1.4 to 5.7; p=0.002). Conclusion NLR (in both univariate and multivariate analysis) and PLR (only in univariate analysis) were prognostic factors in PFTC. NLR and PLR are inexpensive and easy tests to perform. In addition, patients with PFTC who underwent bilateral pelvic and para-aortic lymphadenectomy had longer OS.
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Affiliation(s)
- Kemal Gungorduk
- Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Ibrahim E Ertas
- Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Aykut Ozdemir
- Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Emrah Akkaya
- Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Elcin Telli
- Department of Gynecologic Oncology, Osmangazi University School of Medicine, Eskisehir, Turkey
| | - Salih Taskin
- Department of Gynecologic Oncology, Ankara University School of Medicine, Ankara, Turkey
| | - Mehmet Gokcu
- Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Ahmet Baris Guzel
- Department of Gynecologic Oncology, Cukurova University School of Medicine, Adana, Turkey
| | - Tufan Oge
- Department of Gynecologic Oncology, Osmangazi University School of Medicine, Eskisehir, Turkey
| | - Levent Akman
- Department of Gynecologic Oncology, Ege University School of Medicine, Izmir, Turkey
| | - Tayfun Toptas
- Department of Gynecologic Oncology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ulas Solmaz
- Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Askın Dogan
- Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Mustafa Cosan Terek
- Department of Gynecologic Oncology, Ege University School of Medicine, Izmir, Turkey
| | - Muzaffer Sanci
- Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Aydin Ozsaran
- Department of Gynecologic Oncology, Ege University School of Medicine, Izmir, Turkey
| | - Tayyup Simsek
- Department of Gynecologic Oncology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Mehmet Ali Vardar
- Department of Gynecologic Oncology, Cukurova University School of Medicine, Adana, Turkey
| | - Omer Tarik Yalcin
- Department of Gynecologic Oncology, Osmangazi University School of Medicine, Eskisehir, Turkey
| | - Sinan Ozalp
- Department of Gynecologic Oncology, Osmangazi University School of Medicine, Eskisehir, Turkey
| | - Yusuf Yildirim
- Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Firat Ortac
- Department of Gynecologic Oncology, Ankara University School of Medicine, Ankara, Turkey
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Primary fallopian tube carcinoma: correlation between magnetic resonance and diffuse weighted imaging characteristics and histopathologic findings. J Comput Assist Tomogr 2014; 39:270-5. [PMID: 25373473 DOI: 10.1097/rct.0000000000000178] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the magnetic resonance (MR) and diffusion-weighted (DW) imaging characteristics of primary fallopian tube carcinoma (PFTC). METHODS The clinical, MR, and DW imaging characteristics and pathologic findings of 23 patients with 27 tumors were studied retrospectively. The MR and DW imaging appearance of tumors including laterality, size and shape, architecture, signal intensity, apparent diffusion coefficient (ADC) value, enhancement pattern, hydrosalpinx, and intrauterine fluid collection were evaluated and correlated with pathologic findings. RESULTS Histopathologically, all 27 tumors were serous carcinoma with a unilateral tumor in 19 patients and bilateral tumors in 4 patients. Thirteen patients (57%) with PFTC were misdiagnosed preoperatively, 10 of which as epithelial ovarian carcinoma. The mean (SD) largest diameter was 61 (7) mm. The tumor shape was fusiform, sausagelike, or serpentine in 19 patients (70%) and nodular or irregular in 8 patients (30%). Twenty (74%) of the 27 tumors were solid, and 7 (26%) were cystic-solid. The solid components showed hypointensity to isointensity on T1-weighted imaging, and isointensity to slight hyperintensity on T2-weighted imaging. There were obvious hyperintensity on DW imaging; obvious hypointensity on ADC maps with a mean (SD) ADC value of 0.79 (0.22) × 10 mm; and mild (8/27, 30%), moderate (13/27, 48%), and marked (6/27, 22%) enhancement on contrast-enhanced imaging. Ipsilateral hydrosalpinx, intrauterine fluid collection, and ascites were found in 14 tumors (52%) and 7 (30%) and 5 (22%) patients, respectively. CONCLUSIONS The PFTC has some characteristic MR imaging features. The DW imaging, ADC maps, and ADC values are helpful for the detection and differentiation of PFTC from other pelvic masses.
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Sahu M, Sahoo PK, Sahu MC, Padhy RN. A case of bilateral primary fallopian tube carcinoma. ASIAN PACIFIC JOURNAL OF REPRODUCTION 2014. [DOI: 10.1016/s2305-0500(14)60034-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Primary fallopian tube cancer: Domestic data and up-to-date review. Taiwan J Obstet Gynecol 2014; 53:287-92. [DOI: 10.1016/j.tjog.2014.07.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2014] [Indexed: 12/17/2022] Open
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Horng HC, Teng SW, Lai CR, Chang WH, Chang YH, Yen MS, Wang PHP. Prognostic factors of primary fallopian tube cancer in a single institute in Taiwan. Int J Gynaecol Obstet 2014; 127:77-81. [PMID: 24997471 DOI: 10.1016/j.ijgo.2014.04.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 04/09/2014] [Accepted: 06/04/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To improve the understanding of primary fallopian tube carcinoma (PFTC) through an analysis of possible clinical and pathologic determinants of prognosis. METHODS A retrospective review of the database of a tertiary hospital in Taiwan for 1978-2007 was conducted to identify patients with a diagnosis of PFTC and to evaluate the clinicopathologic features associated with PFTC outcome. RESULTS Fifty-eight patients (mean age 62.5 years) had a diagnosis of PFTC. Stage III/IV disease (55%) and poorly differentiated tumors (52%) were most common. The median follow-up was 93 months (range, 11-333 months). The 5-year disease-free survival rate was 59%, and the overall survival rate was 64%. Factors important in disease-free and overall survival in univariate analysis included the presence of pelvic and/or para-aortic lymph node metastases, International Federation of Gynecology and Obstetrics stage, high preoperative carbohydrate antigen 125 serum level, completion of optimal debulking surgery, and the use of paclitaxel-based chemotherapy; however, only patients with optimal cytoreduction had a decreased hazard of recurrence (hazard ratio [HR] 0.06; 95% confidence interval [CI] 0.01-0.23) and mortality (HR 0.08; 95% CI, 0.02-0.31) in multivariate analysis. CONCLUSION Advanced tumor stage, in particular the presence of lymph node metastases, worsened the prognosis of patients with PFTC. However, optimal debulking surgery significantly improved the prognosis, emphasizing the importance of the treatment strategy.
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Affiliation(s)
- Huann-Cheng Horng
- Division of Gynecology, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Sen-Wen Teng
- Department of Obstetrics and Gynecology, Cardinal Tien Hospital-Hsintien, New Taipei City, Taiwan; Department of Obstetrics and Gynecology, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Chiung-Ru Lai
- Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Pathology, National Yang-Ming University, Taipei, Taiwan
| | - Wen-Hsu Chang
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Nursing, National Yang-Ming University School of Nursing, Taipei, Taiwan
| | - Yen-Hou Chang
- Division of Gynecology, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Ming-Shyen Yen
- Division of Gynecology, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Peng-Hui Peter Wang
- Division of Gynecology, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan; Immunology Center, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan; Infection and Immunity Research, National Yang-Ming University, Taipei, Taiwan.
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