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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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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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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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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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Xiao Y, Liu YX, Li RN, Wei X, Wang QM, Gu QY, Linghu H. Lymphadenectomy in Primary Fallopian Tube Cancer is Associated with Improved Survival. J INVEST SURG 2022; 35:1417-1423. [PMID: 35344678 DOI: 10.1080/08941939.2022.2048142] [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] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND OBJECTIVES Primary fallopian tube cancer (PFTC) shares the same diagnostic and management guidelines with epithelial ovarian cancer (EOC). The LION trail raised concerns regarding the role of systematic pelvic and para-aortic lymphadenectomy during debulking surgery. We aimed to evaluate the significance of lymphadenectomy in PFTC survival. METHODS This retrospective study analyzed the clinical features and survival of patients with PFTC who underwent primary surgery in our center between January 2013 and October 2020. RESULTS Sixty-one patients diagnosed with PFTC were included in the study. Twenty-five (41.0%, 25/61) were diagnosed with FIGO (International Federation of Gynecology and Obstetrics) stages I/II and 36 (59.0%, 36/61) were diagnosed with stage III/IV. Twenty-nine (47.5%, 29/61) underwent pelvic lymphadenectomy with or without para-aortic lymphadenectomy, among which 12 (41.4%, 12/29) had lymph node metastasis confirmed by postoperative pathology. The mean progression-free survival was 60.4 months in the lymphadenectomy group and 37.8 months in the no-lymphadenectomy group (p = 0.042, HR 0.374, 95% CI 0.145-0.966). CONCLUSIONS PFTC is often diagnosed earlier and has a better prognosis than EOC. Most patients with PFTC would benefit from lymphadenectomy. However, the extent to which this association translates to a more diverse population needs to be further identified.
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Affiliation(s)
- Yao Xiao
- Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yue-Xi Liu
- Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ruo-Nan Li
- Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xing Wei
- Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qing-Miao Wang
- Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qiu-Ying Gu
- Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hua Linghu
- Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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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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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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8
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Singh A, Prasad S, Kumar A, Tanwar R. Primary Adenocarcinoma of the Fallopian Tube: A Rare Entity. J Clin Diagn Res 2017; 11:QD03-QD04. [PMID: 29207787 DOI: 10.7860/jcdr/2017/28813.10627] [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: 04/10/2017] [Accepted: 08/01/2017] [Indexed: 11/24/2022]
Abstract
Primary fallopian tube carcinoma is an uncommon gynaecologic malignancy usually seen in postmenopausal females. We present a case of a 66-year-old postmenopausal female who presented with complaint of blood mixed vaginal discharge on and off for past one month. Workup of the patient revealed no abnormality other than presence of atypical squamous cells on Papanicolaou (PAP) smear. MRI showed mildly bulky cervix with around 4cc fluid in endometrial cavity. As the patient remained symptomatic and fluid in endometrial cavity persisted, total abdominal hysterectomy with bilateral salpingo-oophorectomy was done. On histopathological examination, fimbrial end of left tube had features of poorly differentiated papillary serous adenocarcinoma. Postoperatively, she was given chemotherapy and is doing well with more than 3 years of follow up. This case highlights the importance of high suspicion in postmenopausal women with bleeding per vaginum, where there is little to suggest clinically or radiologically.
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Affiliation(s)
- Ankita Singh
- Senior Resident, Department of Obstetrics and Gynaecology, Lok Nayak Hospital, New Delhi, India
| | - Sudha Prasad
- Director Professor, Department of Obstetrics and Gynaecology, Lok Nayak Hospital, New Delhi, India
| | - Ashok Kumar
- Director Professor, Department of Obstetrics and Gynaecology, Lok Nayak Hospital, New Delhi, India
| | - Renu Tanwar
- Professor, Department of Obstetrics and Gynaecology, Lok Nayak Hospital, New Delhi, India
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9
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Kitai S, Kiyokawa T, Tanaka YO, Onoue K, Takahashi H, Saitou M, Okamoto A, Fukuda K. MRI findings for primary fallopian tube cancer: correlation with pathological findings. Jpn J Radiol 2017; 36:134-141. [DOI: 10.1007/s11604-017-0705-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 11/07/2017] [Indexed: 12/29/2022]
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10
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Cancer tubaire primitif chez une patiente ayant une maladie de Crohn et une salpingite chronique : rôle de l’inflammation locale dans la pathogenèse tumorale ? IMAGERIE DE LA FEMME 2017. [DOI: 10.1016/j.femme.2017.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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11
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Eken MK, Kaygusuz EI, Temizkan O, İlhan G, Çöğendez E, Karateke A. Occult serous carcinoma of fallopian tube presenting as supraclavicular lymphadenopathy. Taiwan J Obstet Gynecol 2017; 55:450-2. [PMID: 27343337 DOI: 10.1016/j.tjog.2016.04.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2015] [Indexed: 10/21/2022] Open
Affiliation(s)
- Meryem Kurek Eken
- Department of Obstetrics and Gynecology, Zeynep Kamil Education and Research Hospital, Istanbul, Turkey.
| | - Ecmel Işık Kaygusuz
- Department of Pathology, Zeynep Kamil Education and Research Hospital, Istanbul, Turkey
| | - Osman Temizkan
- Department of Obstetrics and Gynecology, Şişli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
| | - Gülşah İlhan
- Department of Obstetrics and Gynecology, Süleymaniye Education and Research Hospital, Istanbul, Turkey
| | - Ebru Çöğendez
- Department of Obstetrics and Gynecology, Zeynep Kamil Education and Research Hospital, Istanbul, Turkey
| | - Ateş Karateke
- Department of Obstetrics and Gynecology, Zeynep Kamil Education and Research Hospital, Istanbul, Turkey
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Thawait SK, Batra K, Johnson SI, Torigian DA, Chhabra A, Zaheer A. Magnetic resonance imaging evaluation of non ovarian adnexal lesions. Clin Imaging 2015; 40:33-45. [PMID: 26463742 DOI: 10.1016/j.clinimag.2015.07.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 07/17/2015] [Accepted: 07/30/2015] [Indexed: 01/10/2023]
Abstract
Differentiation of nonovarian from ovarian lesions is a diagnostic challenge. MRI (Magnetic Resonance Imaging) of the pelvis provides excellent tissue characterization and high contrast resolution, allowing for detailed evaluation of adnexal lesions. Salient MRI characteristics of predominantly cystic lesions and predominantly solid adnexal lesions are presented along with epidemiology and clinical presentation. Due to its excellent soft tissue resolution, MRI may be able to characterize indeterminate adnexal masses and aid the radiologist to arrive at the correct diagnosis, thus positively affect patient management.
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Affiliation(s)
- Shrey K Thawait
- Department of Radiology, Yale University - Bridgeport Hospital, 267 Grant Street Bridgeport, CT 06610.
| | - Kiran Batra
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287.
| | - Stephen I Johnson
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287.
| | - Drew A Torigian
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia PA 19104.
| | - Avneesh Chhabra
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287.
| | - Atif Zaheer
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287.
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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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Primary Fallopian Tube Clear Cell Adenocarcinoma in Pregnancy: Case Presentation and Review of the Literature. Case Rep Obstet Gynecol 2015; 2015:183243. [PMID: 26090245 PMCID: PMC4452342 DOI: 10.1155/2015/183243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 05/11/2015] [Indexed: 11/18/2022] Open
Abstract
Primary fallopian tube cancer in pregnancy is rare and is even more so for the clear cell variant. Our case is the third case of primary fallopian tube cancer in pregnancy and the first case of clear cell adenocarcinoma of the fallopian tube in pregnancy. The patient presented with increasing pelvic pain starting in the second trimester. Serial ultrasound evaluations were performed and revealed a rapidly growing complex adnexal mass adjacent to the uterus. Her pregnancy was further complicated by spontaneous preterm labor and she delivered prematurely per vaginam at 31 weeks. She underwent an urgent laparotomy in the immediate postpartum period for acute aggravation of her right pelvic pain and fever. The diagnosis of tubal clear cell adenocarcinoma was subsequently made on histopathology examination.
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15
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Metastatic fallopian tube carcinoma presenting as an inguinal hernia. Taiwan J Obstet Gynecol 2015; 54:99-101. [PMID: 25675933 DOI: 10.1016/j.tjog.2014.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2014] [Indexed: 10/24/2022] Open
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16
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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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17
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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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Ma FH, Cai SQ, Qiang JW, Zhao SH, Zhang GF, Rao YM. MRI for differentiating primary fallopian tube carcinoma from epithelial ovarian cancer. J Magn Reson Imaging 2014; 42:42-7. [PMID: 25176611 DOI: 10.1002/jmri.24740] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Accepted: 08/12/2014] [Indexed: 11/09/2022] Open
Affiliation(s)
- Feng Hua Ma
- Department of Radiology; Jinshan Hospital, Shanghai Medical College, Fudan University; Shanghai China
| | - Song Qi Cai
- Department of Radiology; Jinshan Hospital, Shanghai Medical College, Fudan University; Shanghai China
| | - Jin Wei Qiang
- Department of Radiology; Jinshan Hospital, Shanghai Medical College, Fudan University; Shanghai China
| | - Shu Hui Zhao
- Department of Radiology; Jinshan Hospital, Shanghai Medical College, Fudan University; Shanghai China
| | - Guo Fu Zhang
- Department of Pathology; Obstetrics & Gynecology Hospital, Shanghai Medical College, Fudan University; Shanghai China
| | - Ya Min Rao
- Department of Pathology; Obstetrics & Gynecology Hospital, Shanghai Medical College, Fudan University; Shanghai China
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Ghosh S, Goyal P, Sehgal S, Shukla P, Kumar A, Singh S. Primary Fallopian-Tube Carcinoma. J Gynecol Surg 2014. [DOI: 10.1089/gyn.2013.0075] [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)
- Soumyesh Ghosh
- Department of Pathology, Swami Dayanand Hospital, Delhi, India
| | - Prashant Goyal
- Department of Pathology, Swami Dayanand Hospital, Delhi, India
| | - Shelly Sehgal
- Department of Pathology, Swami Dayanand Hospital, Delhi, India
| | - Pritish Shukla
- Department of Pathology, Hindu Rao Hospital, New Delhi, India
| | - Awanindra Kumar
- Department of Pathology, Swami Dayanand Hospital, Delhi, India
| | - Sompal Singh
- Department of Pathology, Swami Dayanand Hospital, Delhi, India
- Department of Pathology, Hindu Rao Hospital, New Delhi, India
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La Parra Casado C, Molina Fàbrega R, Forment Navarro M, Cano Gimeno J. Fallopian tube disease on magnetic resonance imaging. RADIOLOGIA 2013. [DOI: 10.1016/j.rxeng.2012.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Estudio de las enfermedades de las trompas de Falopio mediante resonancia magnética. RADIOLOGIA 2013; 55:385-97. [DOI: 10.1016/j.rx.2012.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Revised: 10/06/2012] [Accepted: 10/14/2012] [Indexed: 10/27/2022]
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22
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Hariprasad P, S H, Srinivas T, Shetty K J. Primary bilateral fallopian tube carcinoma the report of a single case with review of the literature. J Clin Diagn Res 2013; 7:930-2. [PMID: 23814748 DOI: 10.7860/jcdr/2013/5483.2980] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 02/11/2013] [Indexed: 11/24/2022]
Abstract
Primary fallopian tube carcinoma is an extremely uncommon neoplasm of the female genital tract. Primary Fallopian Tube Carcinoma (PFTC) has a clinical and a histological resemblance to Epithelial Ovarian Cancer (EOC). We are reporting a case of PFTC in a 55 year old tubectomized, postmenopausal woman with the non-specific complaints of a watery vaginal discharge and lower abdominal pain. The clinical and radiological findings suggested a bilateral tubo-ovarian abscess. On laprotomy, a bilateral fallopian tube tumour was seen, with a focal extension to the surface of the right ovary from the right fallopian tube. Total abdominal hysterectomy, bilateral adnexectomy andomentectomy, along with excision of the draining lymph nodes, was done. The histopathological examination revealed a bilateral papillary serous carcinoma of the fallopian tube. The patient was treated with adjuvant chemotherapy with Paclitaxel. There was no evidence of any recurrence, after 2 years of regular follow up. The clinical signs and symptoms of fallopian tube neoplasms are usually non-specific. The primary treatment remains a surgical resection, followed by adjuvant chemotherapy or radiation. The prognosis is poor, although long-term survivors have been reported.
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Affiliation(s)
- Prajna Hariprasad
- Assistant Professor, Department of Obstetrics & Gynaecology, Kasturba Medical College , Mangalore, India
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Xu Q, Xu N, Fang W, Zhao P, Mao C, Zheng Y, Mou H. Complete remission of platinum-refractory primary Fallopian tube carcinoma with third-line gemcitabine plus cisplatin: A case report and review of the literature. Oncol Lett 2013; 5:1601-1604. [PMID: 23759738 PMCID: PMC3678517 DOI: 10.3892/ol.2013.1232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 01/23/2013] [Indexed: 11/06/2022] Open
Abstract
Primary Fallopian tube carcinoma (PFTC) is a rare but highly aggressive disease. Currently, treatments are similar to those used in epithelial ovarian carcinoma (EOC), however, there are distinct differences between the two diseases. PFTC tends to recur in the retroperitoneal nodes and distant sites more often than EOC. Limited literature with regard to effective agents in platinum-resistant and -refractory (Pt-R) disease exists, particularly after two lines of consecutive treatment. In this case report, a 47-year-old female with PFTC exhibited recurrence in the liver after postoperative chemotherapy. The patient received paclitaxel and cisplatin combination as first-line chemotherapy and topotecan as a second-line treatment, which is considered platinum-refractory. After the second-line treatment failed, this patient received a gemcitabine plus cisplatin combination as third-line chemotherapy for a total of 6 cycles. The liver metastases regressed rapidly and completely. The patient's progression-free survival (PFS) was 10 months and overall survival (OS) was 45 months. In conclusion, gemcitabine and cisplatin combination is an effective regimen for refractory PFTC even after the failure of two previous lines of consecutive chemotherapy and this warrants further independent investigation.
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Affiliation(s)
- Qiuyi Xu
- Department of Medical Oncology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003 P.R. China
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Yokoyama Y, Futagami M, Fujimoto T, Terada Y, Takatori E, Sugiyama T, Otsuki T, Yaegashi N, Kojimahara T, Kurachi H, Nishiyama H, Fujimori K, Tase T, Mizunuma H. Investigation of the clinicopathological features of fallopian tube malignancy. Oncol Rep 2013; 30:79-84. [PMID: 23633088 DOI: 10.3892/or.2013.2439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Accepted: 04/05/2013] [Indexed: 11/06/2022] Open
Abstract
The present study investigated the clinico-pathological features of fallopian tube malignancy (FTM) and elucidated the biological behavior of this disorder. Data were compiled concerning FTM from 68 patients from 7 institutes. The patients included 60 cases with fallopian tube carcinoma and 8 cases with fallopian tube carcinosarcoma. The clinical stage was stage III or higher in 72% of the cases. A complete response or partial response was achieved in 56 and 10 of the 68 patients with FTM, respectively, indicating a response rate of 97.1%. The median observation period for FTM was 41 months (3 to 126 months). Three of the 19 patients with stage I/II disease (16%) and 31 of the 49 patients with stage III/IV disease (63%) experienced recurrence, with a median progression-free survival of 17.5 months, and a 3-year overall survival of 77.2%. Regarding the site of recurrence, local intraperitoneal recurrence (26.2%) and solitary recurrences in lymph nodes (19.0%) and in the liver (16.7%) were relatively frequent. Secondary debulking surgery (SDS) was performed in 15 patients (44%) out of the 34 recurrent FTMs. Conversely, recurrence was associated with ascites (carcinomatous peritonitis) in 4 of the 34 recurrent patients, but all 4 patients died. The median survival period after recurrence was 28 months: 7.5 and 30 months with and without ascites, respectively (P<0.001). A univariate analysis showed that prognosis was significantly correlated only with whether SDS could be performed. These results suggest that since FTM frequently results in solitary recurrence, aggressive recurrence treatment including SDS could improve prognosis.
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Affiliation(s)
- Yoshihito Yokoyama
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
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25
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Kalampokas E, Kalampokas T, Tourountous I. Primary fallopian tube carcinoma. Eur J Obstet Gynecol Reprod Biol 2013; 169:155-61. [PMID: 23622731 DOI: 10.1016/j.ejogrb.2013.03.023] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 03/07/2013] [Accepted: 03/09/2013] [Indexed: 01/04/2023]
Abstract
Primary fallopian tube carcinoma (PFTC) is a rare gynaecological tumour that accounts for 0.14-1.8% of genital malignancies. The most common age of occurrence is between 40 and 65 years, and the mean age is 55 years. The factors that contribute to its appearance are not well known. Population studies show that the mean incidence of PFTC is 3.6 per million women per annum. Overall survival percentages for patients with PFTC are generally low, in the range of 22-57%. Pre-operative diagnosis is rare and PFTC is usually confirmed by a pathologist, but earlier diagnosis with early clinical manifestation and prompt investigation improves the prognosis. Both PFTC and epithelial ovarian cancer (EOC) are treated with similar surgical and chemotherapy methods. Studies have shown that the prognosis for PFTC is worse than that for EOC or other primary gynaecological tumours. This article reviews and presents the current updates of this rare gynaecological malignancy.
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Affiliation(s)
- E Kalampokas
- University of Athens Medical School, Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, Athens, Greece.
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26
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Alvarado-Cabrero I, Stolnicu S, Kiyokawa T, Yamada K, Nikaido T, Santiago-Payán H. Carcinoma of the fallopian tube: Results of a multi-institutional retrospective analysis of 127 patients with evaluation of staging and prognostic factors. Ann Diagn Pathol 2013. [DOI: 10.1016/j.anndiagpath.2012.10.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Carcinoma de las trompas de Falopio. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2012. [DOI: 10.1016/j.gine.2010.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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29
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Elsokkari I, Napaki S, Greening S, Aghmesheh M. Primary transitional cell carcinoma of the fallopian tube. J Obstet Gynaecol Res 2011; 37:1767-71. [DOI: 10.1111/j.1447-0756.2011.01604.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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30
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Melo A, Fernandes AS, Costa A, Paiva V, Martinho M. Primary adenocarcinoma of the fallopian tube presenting as hydrosalpinx. J OBSTET GYNAECOL 2011; 31:455-7. [PMID: 21627441 DOI: 10.3109/01443615.2011.569778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- A Melo
- Gynaecological Endoscopy Unit, Department of Obstetrics and Gynaecology, Hospital S. João, Porto, Portugal.
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31
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Asymptomatic primary fallopian tube cancer: an unusual cause of axillary lymphadenopathy. Case Rep Obstet Gynecol 2011; 2011:402127. [PMID: 22567506 PMCID: PMC3335533 DOI: 10.1155/2011/402127] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Accepted: 09/13/2011] [Indexed: 11/18/2022] Open
Abstract
Primary Fallopian tube malignancy is considered a rare disease and is often mistaken histologically and clinically for ovarian cancer. The etiology is poorly understood, and it typically presents at an advanced disease stage, as symptoms are often absent in the initial period. As a result, primary fallopian tube cancer is generally associated with a poor prognosis. We present the case of a 45-year-old female who presents with a 5-day history of left axillary swelling and a normal breast examination. Mammogram and biopsy of a lesion in the left breast revealed a fibroadenoma but no other abnormalities. Initial sampling of the axillary node was suspicious for a primary breast malignancy, but histology of the excised node refuted this. PET-CT showed an area of high uptake in the right pelvis, and a laparoscopy identified a tumor of the left fallopian tube which was subsequently excised and confirmed as a serous adenocarcinoma.
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Koo YJ, Im KS, Kwon YS, Lee IH, Kim TJ, Lim KT, Lee KH, Shim JU, Mok JE. Primary fallopian tube carcinoma: a clinicopathological analysis of a rare entity. Int J Clin Oncol 2010; 16:45-9. [PMID: 20878435 DOI: 10.1007/s10147-010-0128-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2010] [Accepted: 08/25/2010] [Indexed: 11/26/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the clinical and pathological features of a rare tumor, primary fallopian tube carcinoma (PFTC). MATERIALS AND METHODS We retrospectively analyzed the medical records of 26 patients who were diagnosed with PFTC at Cheil General Hospital and Women's Healthcare Center between March 1992 and November 2009. RESULTS Median patient age was 54.6 (range 41-69) years, and the mean follow-up period was 59.8 (range 3-200) months. Twenty-one (80.8%) patients had one or more of the following preoperative symptoms: vaginal bleeding, abdominal pain, or a palpable mass. No patient was diagnosed with PFTC preoperatively; 17 (65.4%) patients were diagnosed as having an adnexal mass, six (23.1%) had hydrosalpinx, and three (11.5%) had coexisting endometrial pathology. In seven (26.9%) cases, PFTC was missed during the operation, so an additional surgery was later performed. Ten (38.5%) patients were in stage I, two (7.7%) in stage II, 13 (50%) in stage III, and one (3.8%) in stage IV. The serous type was histologically predominant (76.9%), and most were high grade (76.9%). The 5-year survival rate was 81.7%. CONCLUSION Primary fallopian tube carcinoma is hardly ever diagnosed preoperatively or intraoperatively due to its rarity. Our report may help surgeons by providing more information about the clinicopathological behavior of PTFC so that patients can be appropriately counseled. Further clinical studies should be performed to collect more information about this rare tumor.
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Affiliation(s)
- Yu-Jin Koo
- Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, University of Kwandong, 1-19 Mukjeong-dong, Jung-gu, Seoul 100-380, Korea
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33
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Vicus D, Shaw PA, Finch A, Rosen B, Murphy J, Armel S, Sun P, Narod SA. Risk factors for non-invasive lesions of the fallopian tube in BRCA mutation carriers. Gynecol Oncol 2010; 118:295-8. [DOI: 10.1016/j.ygyno.2010.05.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kocak M, Muberra K, Tasci Y, Yasemin T, Boran N, Nurettin B, Isikdogan S, Zuhal I, Dilbaz B, Berna D. Primary and bilateral tubal carcinoma is associated with long-standing granulomatous inflammation and primary infertility: a case report. J Obstet Gynaecol Res 2010; 36:912-5. [PMID: 20666969 DOI: 10.1111/j.1447-0756.2010.01211.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We report a case of bilateral and primary tubal carcinoma associated with granulomatous inflammation and long-standing primary infertility. A 38-year-old woman with a 17-year history of primary infertility presented with lower abdominal pain and granulomatous inflammation in the endometrial biopsy. Bilateral adnexal masses measuring 4 and 6 cm in size were detected and the serum cancer antigen 125 level was 141 IU/ml. Laparoscopic surgical exploration and frozen section on the resected tubes revealed bilateral fallopian tube adenocarcinoma and then a staging laparotomy was performed. Histopathological examination showed a primary bilateral Grade 2 tubal serous adenocarcinoma of Stage 1b associated with granulomatous salpingitis. Primary fallopian tube carcinomas in young women are extremely rare gynecological tumors that are infrequently diagnosed prior to surgical exploration and their cause is unknown. A definitive diagnosis could be made on the histopathological examination in our case with the evidence of chronic pelvic inflammation. Our findings suggest that chronic pelvic inflammation may play a role in carcinogenesis in the tubes of infertile women.
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Affiliation(s)
- Muberra Kocak
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Health Research Hospital, Ankara, Turkey
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Abstract
INTRODUCTION Primary fallopian tube carcinoma is extremely rare, making 0.3-1.6% of all female genital tract malignancies. Although the etymology of this tumor is unknown, it is suggested to be associated with chronic tubal inflammation, infertility, tuberculous salpingitis and tubal endometriosis. High parity is considered to be protective. Cytogenetic studies show the disease to be associated with over expression of p53, HER2/neu and c-myb. There is also some evidence that BRCA1 and BRCA2 mutations have a role in umorogeneis. CLINICAL FEATURES The most prevailing symptoms with fallopian tube carcinoma are abdominal pain, abnormal vaginal discharge/bleeding and the most common finding is an adnexal mass. In many patients, fallopian tube carcinoma is asymptomatic. DIAGNOSIS Due to its rarity, preoperative diagnosis of primary fallopian tube carcinoma is rarely made. It is usually misdiagnosed as ovarian carcinoma, tuboovarian abscess or ectopic pregnancy. Sonographic features of the tumor are non-specific and include the presence of a fluid-filled adnexal structure with a significant solid component, a sausage-shaped mass, a cystic mass with papillary projections within, a cystic mass with cog wheel appearance and an ovoid-shaped structure containing an incomplete separation and a highly vascular solid nodule. More than 80% of patients have elevated pretreatment serum CA-125 levels, which is useful in follow-up after the definite treatment. TREATMENT The treatment approach is similar to that of ovarian carcinoma, and includes total abdominal hysterectomy and bilateral salpingo-oophorectomy. Staging is followed with chemotherapy.
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Abstract
Menometrorrhagia is a frequent cause of medical consulting. After a clinical examination showing the uterine origin of bleeding and that excludes a cervical or vulvo-vaginal origin, transvaginal sonography (TVS) represents the first-line technique examination. TVS allows to identify endometrial diseases (atrophy, polyps or diffuse hyperplasia), endometrial carcinoma, myometrial disorders (adenomyosis, leiomyoma or vascular abnormalities), and adnexal disorders. Color Doppler sonography and hysterosonography are useful complementary tools for ultrasound performance improvement. MR imaging should be performed if TVS is not contributive or is highly recommended for staging of uterine cancers. All these techniques provide useful information for optimal planning treatment.
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Affiliation(s)
- M Bazot
- Hôpital Tenon, service de radiologie, 4, rue de la Chine, 75970 Paris cedex 20, France.
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37
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Kim YM, Jung MH, Kim DY, Kim JH, Kim YT, Nam JH. Systematic Lymphadenectomy Improves Survival in Patients with Advanced-Stage Primary Fallopian Tube Cancer. TOHOKU J EXP MED 2009; 218:5-9. [DOI: 10.1620/tjem.218.5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Yong Man Kim
- Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center
| | - Min Hyung Jung
- Department of Obstetrics and Gynecology, School of Medicine, Kyung Hee University, Kyung Hee Medical Center
| | - Dae-Yeon Kim
- Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center
| | - Jong Hyeok Kim
- Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center
| | - Young Tak Kim
- Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center
| | - Joo Hyun Nam
- Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center
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Nowee ME, Dorsman JC, Piek JMJ, Kosma VM, Hämäläinen K, Verheijen RHM, van Diest PJ. HER-2/neu and p27Kip1 in progression of Fallopian tube carcinoma: an immunohistochemical and array comparative genomic hybridization study. Histopathology 2007; 51:666-73. [PMID: 17927588 DOI: 10.1111/j.1365-2559.2007.02850.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To determine expression of p53, HER-2/neu and p27(Kip1) in serous Fallopian tube carcinoma (FTC) in relation to stage and grade, and to investigate DNA copy number changes of HER-2 and P27KIP1 as a potential mechanism of altered expression status. METHODS AND RESULTS Immunohistochemistry was performed on 28 serous FTCs and 10 normal Fallopian tubes. p53 protein accumulated and p27(Kip1) was down-regulated significantly in early-stage FTCs compared with normal Fallopian tubes. HER-2/neu overexpression was absent in normal Fallopian tubes and in all stage I FTCs (n = 6) but present in 57% (12/21) of advanced-stage FTCs. No differences in expression between grade 2 and 3 tumours were detected. HER-2 gain/amplification was found by array comparative genomic hybridization in 23% (3/13) of analysed FTCs and all showed overexpression. HER-2/neu overexpression also occurred without DNA copy number changes in three other cases. For p27(Kip1), expression and DNA copy number were unrelated. CONCLUSIONS p53 accumulation and p27(Kip1) down-regulation seem to be early events in Fallopian tube carcinogenesis. HER-2/neu showed overexpression, caused by gain/amplification in 50%, and may be involved in progression of FTC. These data contribute to a better understanding of the molecular carcinogenesis of FTC and to possible new therapeutic approaches.
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Affiliation(s)
- M E Nowee
- Department of Obstetrics and Gynaecology, VU University Medical Centre, Amsterdam, The Netherlands
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41
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Nowee ME, Snijders AM, Rockx DAP, de Wit RM, Kosma VM, Hämäläinen K, Schouten JP, Verheijen RHM, van Diest PJ, Albertson DG, Dorsman JC. DNA profiling of primary serous ovarian and fallopian tube carcinomas with array comparative genomic hybridization and multiplex ligation-dependent probe amplification. J Pathol 2007; 213:46-55. [PMID: 17668415 DOI: 10.1002/path.2217] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Primary serous ovarian carcinoma (OVCA) and serous Fallopian tube carcinoma (FTC), both belonging to the BRCA-linked tumour spectrum, share many properties and are treated similarly. However, a detailed molecular comparison has been lacking. We hypothesized that comparative genomic studies of serous OVCAs and FTCs should point to gene regions critically involved in their tumorigenesis. Array comparative genomic hybridization (array CGH) analysis indicated that serous OVCAs and serous FTCs displayed common but also more distinctive patterns of recurrent changes. Targeted gene identification using a dedicated multiplex ligation-dependent probe amplification (MLPA) probe set directly identified EIF2C2 on 8q as a potentially important driver gene. Other previously unappreciated gained/amplified genes included PSMB4 on 1q, MTSS1 on 8q, TEAD4 and TSPAN9 on 12p, and BCAS4 on 20q. SPINT2 and ACTN4 on 19q were predominantly found in FTCs. Gains/amplifications of CCNE1 and MYC, often in conjunction with changes in genes of the AKT pathway, EVI1 and PTK2, seemed to be involved at earlier stages, whereas changes of ERBB2 were associated with advanced stages. The only BRCA1-mutated FTC shared common denominators with the sporadic tumours. In conclusion, the data suggest that serous OVCAs and FTCs, although related, exhibit differences in genomic profiles. In addition to known pathways, new genes/pathways are likely to be involved, with changes in an miRNA-associated gene, EIF2C2, as one important new feature. Dedicated MLPA sets constitute potentially important tools for differential diagnosis and may provide footholds for tailored therapy.
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Affiliation(s)
- M E Nowee
- Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, The Netherlands
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The incidence of primary fallopian tube cancer in the United States. Gynecol Oncol 2007; 107:392-7. [DOI: 10.1016/j.ygyno.2007.09.018] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2007] [Revised: 09/11/2007] [Accepted: 09/14/2007] [Indexed: 01/29/2023]
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43
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Elsandabesee D, Scott-Barrett S, Crocker SG. Preoperative diagnosis of early fallopian tube carcinoma. J OBSTET GYNAECOL 2007; 27:99-100. [PMID: 17365483 DOI: 10.1080/01443610601076283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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44
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Riska A, Pukkala E, Scélo G, Mellemkjaer L, Hemminki K, Weiderpass E, McBride ML, Pompe-Kirn V, Tracey E, Brewster DH, Kliewer EV, Tonita JM, Kee-Seng C, Jonasson JG, Martos C, Boffetta P, Brennan P. Second primary malignancies in females with primary fallopian tube cancer. Int J Cancer 2007; 120:2047-51. [PMID: 17266029 DOI: 10.1002/ijc.22562] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Primary fallopian tube cancer (PFTC) is a rare disease, and its aetiological factors are poorly understood. Studies on PFTC in the setting of 2nd primary malignant neoplasms can provide clues on aetiology and also define the possible side effects of different treatment modalities for PFTC. A cohort of 2,084 cases with first PFTC was extracted from the data from 13 cancer registries from Europe, Canada, Australia and Singapore and followed for second primary cancers within the period 1943-2000. Standardized incidence ratios (SIRs) were calculated and Poisson regression analyses were done to find out the RRs related to age at, period of and time since the PFTC diagnosis. There were 118 cancer cases observed after first PFTC (SIR 1.4, 95%CI 1.1-1.6). Elevated SIRs were seen for colorectal cancer (1.7, 95%CI 1.0-2.6), for breast cancer (1.5, 95%CI 1.1-2.2), for bladder cancer (2.8, 95%CI 1.0-6.0), for lung cancer (1.8, 95% CI 0.9-3.2) and for nonlymphoid leukaemia (3.7, 95%CI 1.0-9.4). Significant risk increases were detected for colorectal cancer during the 2nd to 5th year after the first PFTC diagnosis, for breast cancer in follow-up 10+ and for nonlymphoid leukaemia during the 2nd to 10th year. The clustering of cancers of the lung and bladder in PFTC patients may suggest shared smoking aetiology. The excess of colorectal and breast cancers after PFTC may indicate a genetic aetiology.
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Affiliation(s)
- Annika Riska
- Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Finland
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Abstract
PURPOSE Primary fallopian tube carcinoma (PFTC) is a rare tumor that histologically and clinically resembles epithelial ovarian cancer (EOC). The purpose of this study is to review the current available literature data on PFTC. PATIENTS AND RESULTS Early clinical manifestation and prompt investigation often lead to diagnosis at an early stage of disease. However, the diagnosis of PFTC is rarely considered preoperatively and is usually first appreciated by the pathologist. Surgical staging/management and the use of chemotherapy follow the concepts used in epithelial ovarian cancer (EOC). In contrast to EOC is the importance of early lymphatic spread in this disease. The earlier diagnosis of PFTC leads to an apparent better survival compared with EOC. However, as with EOC, stage and residual tumor are the most important prognostic variables. CONCLUSION Until more extensive clinical research has been performed, ovarian carcinoma management principles should be used in clinical practice.
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Affiliation(s)
- Dimitrios Pectasides
- Second Department of Internal Medicine, Propaedeutic, Oncology Section, Attikon University Hospital, Rimini 1, Haidari, Athens, Greece.
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