Primary carcinoma of the fallopian tube.
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A case of endometrioid carcinoma of the fallopian tube is reported with histologic description and clinical follow-up of four years. Only two other cases have been documented previously. This case is thought to be unique as the carcinoma arose in a benign endometrioid tumor. Inferences concerning Mullerian duct expression and neoplasia are reviewed.
Two asymptomatic cases of adenomatoid tumor, confined to the lamina propria of the tubal fimbria, are presented, and their location within strictly Müllerian territory is offered as indirect evidence for the Müllerian origin of this lesion. To stress the individuality of this distinct entity, the name of Müllerian mesothelioma is suggested.
Primary Fallopian tube carcinoma is rarely diagnosed preoperatively. We present the case of a 69-year-old woman with primary tubal carcinoma, which was diagnosed preoperatively on the basis of the cytological finding, characteristic features on transvaginal sonography, transvaginal color flow imaging and elevated CA-125. Transvaginal color Doppler imaging demonstrated the tumor revealed areas of neovascularization with characteristic low impedance (resistance index, 0.34 and pulsatility index, 0.62). Pathohistologic confirmation of the clearcell carcinoma has been done.
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A middle-aged woman presented with a pelvic mass. Pathologic examination of the resected specimen revealed a primary adenosquamous carcinoma of the left fallopian tube. Special studies supported the concept of the neoplastic cells differentiating along two major pathways, squamous cell carcinoma and mucin-producing adenocarcinoma.
Microscopic evaluation of a human fallopian tube following end-to-end anastomosis over a polyethylene stent was performed 10 days after the initial surgical procedure. The stent was removed on the 3rd postoperative day. Examination of the excised tube revealed a patent lumen without any evidence of mucosal compromise. The submucosa adjacent to the anastomotic site revealed a mild polymorphonuclear leukocytic infiltration, although a marked inflammatory response was observed around the 5-0 chromic sutures used in the reanastomosis. This case and recent animal studies suggest that early removal of the stent does not appear to jeopardize the patency of the tube and may be preferable to removal after 3 to 4 months.
Histologic findings in 133 previously ligated fallopian tubes of women who underwent subsequent hysterectomy and bilateral salpingectomy were compared with those of 50 normal fallopian tubes and related to four surgical procedures for sterilization. Dilatation of proximal tubal lumen, flattening of the folds, polyps, and increase of mitotic activity of the epithelium was subsequent to tubal occlusion in any case, regardless of the type of sterilization. After sterilization by ring, ligation, and coagulation, the incidence of epithelial inclusions was significantly different from that observed after sterilization by clips. Focal endometriosis was only found after tubal ligation and coagulation. It is suggested that epithelial inclusions were the result of surviving fragments of tubal epithelium translocated in the tubal wall during the procedure, and that endometriosis was caused by implantation of expelled menstrual products through the open lumen into the healed ligation area.
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Omentectomy was conducted on a 49 year old patient at the Dept. of Surgery of the UFK Berlin-Charlottenburg because of a mucinous adenocarcinoma, without prior detection of the primary tumour site. Relaparotomy revealed proliferative mucinous adenoma of the Fallopian tube and a consecutive pseudomyxoma peritonei. Up to now, this seems to be the first case report of a mucinous adenoma of the Fallopian tube.
Discontinuous vaginal discharge in two patients, caused by a carcinoma of the fallopian tube, was misinterpreted as urinary incontinence for months. Complexes of atypical glandular epithelia in the cervico-vaginal smears and detection of adnexal tumors indicated the correct diagnosis.
The clinical and pathologic features of four examples of a distinctive intraluminal papillary epithelial tumor of the fallopian tube are described. All four cases occurred in fallopian tubes removed in the immediate postpartum period. The nature of this lesion and its relationship to previously described epithelial lesions of the fallopian tube are discussed.