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Results for “Fallopian Tube Neoplasms”

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PubMed1981

Unusual ovarian, tubal and pelvic mesothelial inclusions in patients with endometriosis.

Unusual mesothelial inclusions were observed in ovaries, fallopian tubes and pelvic wall in six out of 57 patients with endometriosis and in none of 100 ovaries without endometriosis. Although of the same origin as the common ovarian epithelial inclusion cysts, these mesothelial inclusions were different being small, closely packed mesothelial cell nests with or without central lumina and occasionally demonstrating a pseudoinfiltrative pattern, rather than the cystically dilated, non-crowded glands lined by a variety of Müllerian type epithelia. Histochemical reactions of these mesothelial inclusions were similar to those obtained in normal mesothelium, but differed from those seen in common epithelial inclusion cysts, endometriosis and adenocarcinoma. The association of these inclusions with endometriosis suggests that a common stimulus is responsible for the development of both conditions from the multipotential pelvic mesothelium.

Adenocarcinoma↗
PubMed2003

Management of advanced-stage primary carcinoma of the fallopian tube: case report and literature review.

Primary carcinoma of the fallopian tube is a very unusual gynecologic malignancy that accounts for less than 1% of all malignancies of the female genitalia. A 55-year-old, gravida 7, para 3 woman presented with no gynecologic complaints other than backache. TVS demonstrated a 35 x 25 mm heterogeneous mass that was not clearly separated from the left ovary, and another 31 x 14 mm cystic septated lesion in the left ovary region. Pelvic MRI demonstrated a 35 x 35 x 20 mm left adnexal mass that enhanced with contrast and a neighboring tubular-cystic mass. Upper and lower gastrointestinal endoscopy revealed no malignancy. Serum CA 125-level was merkedly elevated at 369 U/ml (normal < 35 U/ml). Laparotomy revealed left hydrosalpinx and a papillary-fimbrial mass. Pelvic lymph node metastases were observed. Frozen-section analysis identified the mass as a serous adenocarcinoma. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, appendectomy, omentectomy, pelvic and para-aortic lymph node dissection, and peritoneal washing were performed. The definitive histopathological diagnosis was primary serous adenocarcinoma of the fallopian tube with six of 25 lymph node biopsies showing metastasis. Six cycles of paclitaxel (175 mg/m2) plus cisplatin (75 mg/m2) combinatin chemotherapy were administered with 3-week intervals between cycles. Second-look laparotomy was performed; there was no evidence of disease. At the time of writing 12 months after the second-look laparotomy, she was still disease-free.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1980

[Hysterosalpingectomy. A contribution to the prevention of primary tubal neoplasms].

Reporting on 5103 hysterectomies performed within a period of 8 years (1970-1977), with a persistent high frequency of the vaginal approach (93,0%) independent of the dignity of the disease, the importance of a simultaneous bilateral salpingectomy is emphasized. Age and parity of the patients as well as size of uterus and indication for surgery were of little influence on the mode of operation. 3 carcinomas of the uterine tube, i.e. 0,43% of all gynecological neoplasms in our collective and a total of 701 other genital carcinoma were treated. With reference to current literature the clinical problems of primary malignant tumors of the uterine tube are discussed and the 3 cases of preoperatively undetected carcinoma are presented to underline the diagnostic and prognostic complexity. As a prophylactic measure hysterosalpingectopmy is recommmended for every uterus extirpation.

Adult↗
PubMed2004

Intraperitoneal serous adenocarcinoma: a critical appraisal of three hypotheses on its cause.

OBJECTIVE: Serous ovarian, Fallopian tube, and peritoneal adenocarcinomas are remarkably similar, both in their morphology, as well as in their clinical behavior. Despite extensive clinical and fundamental research, controversy still exists on the origin of serous female adnexal tumors. Difficulties in identification of site of origin at late stage the of disease at detection, when ovary, Fallopian tube, and the abdominal cavity are usually all involved, in addition to their macroscopic and microscopic resemblance, are major causes of this debate. In 3 hypotheses, 3 possible tissues of origin are proposed: the ovarian surface epithelium, the Fallopian tube epithelium, and the secondary Mullerian system. STUDY DESIGN: We searched for all peer-reviewed articles and reviews that examined "serous ovarian carcinoma," "Fallopian tube carcinoma," "Mullerian system," "ovarian surface epithelium," "tubal epithelium," and "peritoneal." We included only articles that could give information on the origin of serous carcinomas. Additional articles were added by examining references of overview articles in relevant fields. RESULTS: Discussed are the experimental data underlying these hypotheses. CONCLUSION: An attempt is made to integrate the 3 hypotheses into a comprehensive model of serous intraperitoneal adenocarcinogenesis. It can be concluded that the Fallopian tubes play a major role in the development of female serous cancer.

Animals↗
PubMed1988

Expression of IgA and secretory component in the normal and in adenocarcinomas of Fallopian tube, endometrium and endocervix.

The occurrence and localization of IgA and secretory components (SC) were examined in the normal and in adenocarcinomas of Fallopian tube, endometrium and endocervix. IgA-containing immunocytes were identified in the stroma of 90% of normal Fallopian tubes. It is suggested that the Fallopian tube may have an immunological function and may, together with the endocervix, constitute the local secretory immune system of the female genital tract. IgA and SC were frequently demonstrated in the cytoplasm and luminal secretion of adenocarcinomas of the endocervix, endometrium and Fallopian tube. This study has shown a decrease in immunoreactivity of SC among poorly differentiated adenocarcinomas but has failed to demonstrate any correlation between the expression of IgA and the degree of differentiation of the tumours. Secretory component appears, therefore, to be more useful than IgA as an indicator of secretory activity and differentiation of adenocarcinomas of the female genital tract.

Adenocarcinoma↗
PubMed1985

Surgery and radiotherapy in the treatment of primary carcinoma of the Fallopian tube--report of 18 cases.

Eighteen cases of primary Fallopian tube carcinoma referred to Christie Hospital, Manchester over the years 1966 to 1980 are reviewed. The overall 5-year survival rate was 14.4%. Treatment by total hysterectomy and bilateral salpingo-oophorectomy resulted in a longer survival compared to bilateral salpingo-oophorectomy or removal of the tumour alone. Postoperative radiotherapy did not seem to improve survival.

Adult↗
PubMed2005

Risk-reducing salpingo-oophorectomy in BRCA mutation carriers: role of serial sectioning in the detection of occult malignancy.

PURPOSE: Women who carry deleterious mutations of BRCA1 or BRCA2 genes have up to a 54% lifetime risk of developing ovarian cancer. After childbearing, women at high risk increasingly choose bilateral risk-reducing salpingo-oophorectomy (RRSO). Two recent studies of BRCA mutation carriers reported occult malignancy in 2.5% of women undergoing RRSO. This study aimed to increase this detection rate using a protocol. METHODS: In 1996, the University of California San Francisco Gynecologic Oncology Program instituted a surgical-pathologic RRSO protocol that was composed of complete removal and serial sectioning of both ovaries and fallopian tubes, peritoneal and omental biopsies, and collection of peritoneal washings for cytology. We report the pathologic findings in 67 BRCA mutation carriers according to the degree of adherence to this protocol. RESULTS: Of the 67 procedures, the protocol was followed completely or partially in 41 (61%). Seven occult malignancies were discovered, four in the fallopian tube and three in the ovaries. Six of these were microscopic, and all seven (17%) were found in specimens from complete or partial protocol procedures as opposed to standard procedures (P = .026). Other variables such as age, parity, BRCA1 or BRCA2 mutation, or type of surgery did not alter the strong effect of protocol procedure on the cancer detection rate. CONCLUSION: A rigorous operative and pathologic protocol for RRSO increases the detection rate of occult ovarian malignancy in BRCA mutation carriers nearly seven-fold. If confirmed, this finding will alter postoperative management because additional staging, chemotherapy, and follow-up may be necessary in affected women.

Adult↗
PubMed2005

Immunohistochemical detection of glucose transporter GLUT1 in benign and malignant fallopian tube epithelia, with comparison to ovarian carcinomas.

CONTEXT: Enhanced expression of GLUT1, a facilitative glucose transporter found on red blood cells, blood-brain barrier, and perineurium, has been described in a large spectrum of epithelial malignancies. OBJECTIVE: We present an immunohistochemical survey of GLUT1 expression in benign and malignant fallopian tube epithelia, and compare serous carcinomas of the fallopian tube and ovary. DESIGN: One hundred two routinely fixed and processed archival specimens (36 benign fallopian tubes, 29 primary tubal adenocarcinomas, and 37 primary ovarian adenocarcinomas) were immunostained with rabbit anti-GLUT1 and developed with streptavidin-biotin/diaminobenzidine. Only distinct membrane staining was scored positively (1+ to 3+). RESULTS: Benign tubes (n = 36) were either negatively stained (58.3%) or displayed rare weak staining (0.5+ to 1+, rarely 2+; 41.7%); of the latter, 4 specimens showed chronic salpingitis, and 6 showed hyperplasia (epithelial tufting and stratification). A case of florid hyperplasia with atypia in a BRCA1-positive patient was GLUT1 negative. Twenty-three (79.3%) of 29 tubal carcinomas were positively stained. Staining ranged from focal/scattered foci (n = 15) to multifocal/extensive (n = 8). Of the 6 nonstaining tubal carcinomas, 3 were undifferentiated. Nineteen tubal carcinoma sections showed residual benign epithelium, which was consistently nonstaining. Very frequently, GLUT1 staining intensified in cells furthest from stroma/ stromal capillaries and/or bordering necrotic zones. On average, GLUT1 staining in primary fallopian tube cancers was less extensive than in primary ovarian adenocarcinomas. CONCLUSIONS: GLUT1 immunostaining of fallopian tube adenocarcinomas was substantially stronger and more extensive than staining of benign tubal epithelium, consistent with previously described findings in carcinomas versus benign tissues from many primary sites. The frequent localization of GLUT1 positivity to regions most distal from stroma/stromal capillaries is consistent with known activation of GLUT1 expression by hypoxia-sensing cellular pathways and may constitute a survival advantage under hypoxic conditions present in malignancy. The difference in extent of GLUT1 staining between primary tubal and primary ovarian serous adenocarcinomas is discussed.

Adenocarcinoma↗
PubMed1999

[Cerebral ischemia as initial manifestation of neoplastic low-malignancy changes. 2 case reports and review of the literatures].

Thrombembolic events as paraneoplastic complications in malignant disease account for severe morbidity and mortality in these patients. In some cases disturbance in hemostasis is the first manifestation of a neoplastic process. We report the cases of two patients with cerebral and extracerebral vessel occlusions, in whom epithelial tumors of low malignant potential (borderline-tumors) of ovary and peritoneum were diagnosed later on. In one case the removal of the tumor stopped the coagulation problems. The second patient died a few days after the first symptoms with devastating multiple vessel occlusion. In stroke of unknown aetiology a paraneoplastic process should be kept in mind. The diagnosis is more probable with recurrent thrombembolism in different body regions and when warfarin therapy was ineffective. Thoughtful coagulation studies and a tumor search program is recommended in these cases.

Adult↗
PubMed1985

Infertility surgery with the laser beam.

The results of the use of CO2 laser in infertility surgery are encouraging. The unique properties of CO2 laser--precision of application, minimal bleeding, rapid healing, and minimal scarring--are beneficial for infertility surgery. It remains to be seen, however, whether the pregnancy rate in "laser patients" is superior to that in "conventional surgical patients." A well-controlled, randomized study and a long-term follow-up period are required to clarify this matter. A good understanding of the basic concepts of laser physics and a familiarity with the laser instruments are mandatory for the laser surgeon. A well-informed operating room staff will certainly be helpful in conducting effective and safe laser surgery. For example, all flammable and explosive material must be removed from the laser area, and protective coverings for the eyes must be worn by all personnel. Simplification, reduction in the bulk of the present instruments, and the development of a flexible CO2 laser transmission fiber that can be utilized through an endoscope will be beneficial.

Endometriosis↗
PubMed2005

Additional salpingectomy after previous prophylactic oophorectomy in high-risk women: sense or nonsense?

OBJECTIVES: Since BRCA1/2 germ line mutation carriers are also at a higher risk of developing fallopian tube carcinoma, resection of the fallopian tubes is currently included at the time of risk reducing surgery. In this study, we comment on the need of additional bilateral prophylactic salpingectomy (BPS) following previous bilateral prophylactic oophorectomy (BPO) in women at high risk of ovarian cancer. METHODS: Retrospectively, the medical files of 42 high-risk women, who had undergone BPO only, were reviewed. RESULTS: In our center, risk-reducing surgery consisted of BPO only for 42 women. Twenty-seven women received an informative letter in which counseling for additional BPS was offered. In total, 15 women opted for additional BPS. Surgery was performed with a mean interval of 65 months (range 6-101) in 10 BRCA1 carriers, one BRCA2 carrier, one BRCA1 and 2 carrier, and three women with non-informative test results. The procedure was readily done by laparoscopy in 13 women and two needed a laparotomy. No post-operative complications had occurred. Histopathological examination revealed no malignancy. CONCLUSIONS: We believe that additional risk reduction of cancer necessitates BPS in BRCA1/2 carriers after previous BPO. BPS after previous BPO was easily performed. Today, physicians should include resection of the fallopian tube at prophylactic surgery in high-risk women and should consider additional BPS in women who have undergone BPO only.

Adult↗
PubMed2006

Advances in the recognition of tubal intraepithelial carcinoma: applications to cancer screening and the pathogenesis of ovarian cancer.

Prophylactic salpingo-oophorectomies from women with BRCA mutations (BRCA+) have identified the tube as a frequent site of early pelvic serous carcinoma (tubal intraepithelial carcinoma [TIC]). These observations have implications for both the early recognition of pelvic serous carcinoma in susceptible women and determining the ultimate site of origin for pelvic serous carcinomas. Moreover, the unique pathology of TIC has shifted attention from the more exuberant proliferations mentioned in prior studies to a spectrum of neoplastic atypias that can be morphologically subtle. This review addresses a multitude of epithelial changes; benign, malignant, and an intriguing third group, which we term "p53 signatures," is found in benign, nonciliated epithelium and stain intensely positive for p53. Understanding all 3 is important for the proper management of women undergoing prophylactic salpingo-oophorectomy and possibly formulating an integrated model for the pathogenesis of serous carcinoma in the reproductive tract. A protocol for sectioning and extensively examining the fimbriated end (SEE-FIM), and its rationale, is described.

Biomarkers, Tumor↗
PubMed1995

The effectiveness of cryoendoscopic treatment for tubal infertility.

Seventy-three women experienced bilateral proximal tubal occlusion caused by adhesions or polyps arising from the uterotubal junction in at least one tube. There were no other identifiable causes of infertility. All patients were treated with cryosurgery, which restored tubal patency in 61 (83.6%). Of 45 women with restored patency, who were followed 6 to 12 months, 20 (27.4% of 73) conceived and 16 (21.9%) delivered viable babies.

Adult↗