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PubMed1988

Primary adenocarcinoma localized to the fallopian tubes: report on 33 cases.

Thirty-three cases of primary adenocarcinoma localized to the fallopian tubes were analyzed according to prognostic factors such as depth of infiltration, tumor differentiation, and lymph vessel invasion. Fifteen patients (45, 5%) died of recurrence within 5 years. Only for positive vessel invasion was the survival significance worse. Combination chemotherapy seems promising compared to radiotherapy in these early stages.

Adenocarcinoma↗
PubMed1989

Clinical study of primary carcinoma of the fallopian tube: experience with 15 cases.

Between 1950 and 1986, fifteen cases of primary carcinoma of the fallopian tube were diagnosed and treated at the Cancer Institute Hospital, Tokyo. These cases constituted 0.14% of the total number of gynecologic malignancies at the hospital during that period. The average age of the 15 patients was 55.7 years. The most frequent symptom was atypical genital bleeding, seen in 12 cases (80%). Massive watery discharge was seen in 4 cases (27%). In preoperative cytologic examination, 6 cases (40%) were positive for cancer. All cases underwent operation as therapy. Postoperative irradiation, adjuvant chemotherapy, and/or second- or third-look operations were also performed. Histopathologically, all materials were found to be adenocarcinoma. Four cases were well differentiated, eight were moderately differentiated, and three were poorly differentiated. As for the prognosis, 7 patients were followed more than 5 years postoperatively. The 5-year survival rate was 57% (4/7). In stage I cancers, the 5-year survival rate was 80% (4/5). The prognosis of stage I cancer patients was estimated to be rather good.

Adenocarcinoma↗
PubMed1989

Carcinosarcomas and mixed Müllerian tumors of the fallopian tube.

Four cases of carcinosarcoma and mixed müllerian tumors of the fallopian tube are presented. Each patient presented with abnormal bleeding and a pelvic mass. All underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, staging, and cytoreduction. Disease was limited to the pelvis in two patients, analogous to FIGO stage IIB ovarian carcinoma; the other two patients had upper abdominal disease, analogous to FIGO stage III. The primary tumors were intraluminal and papillary. There were equal amounts of carcinoma and sarcoma in three tumors; in one, sarcoma constituted only a small intraluminal focus. The sarcoma was predominantly homologous, with foci of heterologous elements present in three tumors. Adjuvant therapy consisted of pelvic radiation in two patients. One patient died of inanition within one year of diagnosis. The other patient, who had the small focus of sarcoma within a stage IIB carcinoma, had an 11-year disease-free interval before retroperitoneal recurrence of carcinoma. Two patients received chemotherapy. A stage IIB patient, after pelvic radiation, received Cytoxan and Adriamycin; she is clinically free of disease after 6 years. A stage III patient lived over 3 years after treatment with multiple agents; she responded to Cytoxan and cis-platinum before suffering a systemic relapse and death.

Adult↗
PubMed1989

Fallopian tube carcinoma: a clinicopathological study of 17 cases.

From 1969 through 1986, 17 patients with primary adenocarcinoma of the fallopian tube were treated at the Loma Linda University Medical Center. Stages I, II, and III of the disease were present in 6, 5, and 6 patients, respectively. The mean age of the patients was 59.9 years. Vaginal bleeding or discharge (57%), followed by abdominal pain or discomfort (29%), was the most common symptom in our patients. A palpable pelvic mass was detected in two-thirds of the patients. One case of carcinosarcoma, one case of mixed mesodermal tumor, and one case of endometrioid carcinoma are included. No patient in this series had a correct preoperative diagnosis. Therapy consisted of surgical resection, usually followed by various combinations of adjuvant radiation therapy and/or chemotherapy. The overall 5-year survival rate was 31%. Five patients (29%) are alive without evidence of disease. This study supports the need for collaboration among large centers to define the optimal adjuvant therapy of this disease. In the absence of the desired treatment protocols, such lesions should be approached in a manner similar to that used for ovarian cancers.

Adenocarcinoma↗
PubMed1989

Posthysterectomy carcinoma of the fallopian tube presenting as vaginal adenocarcinoma: a case report.

The clinical and pathological features of a case of adenocarcinoma of the fallopian tube with a unique presentation are described. The 68-year-old patient presented with vaginal bleeding 25 years after a vaginal hysterectomy. Pelvic examination revealed a 0.5-cm nodule of tumor involving the mucosa of the vaginal apex. At laparoscopy, the left fallopian tube was dilated and adherent to the vaginal vault. Pathological examination of the upper vaginectomy and bilateral salpingo-oophorectomy specimen revealed a primary papillary adenocarcinoma of the left fallopian tube that had invaded directly into the mucosa of the vaginal apex. Vaginal involvement, either at the time of presentation or subsequently in the course of the disease, is very rare in patients with carcinoma of the fallopian tube.

Adenocarcinoma, Papillary↗
PubMed1989

Tissue expression of CA 125 in benign and malignant lesions of ovary and fallopian tube: a comparison with CA 19-9 and CEA.

Sections of formalin-fixed and paraffin-embedded tissue specimens of 11 normal ovaries and tubes, 13 tubo-ovarian abscesses, 3 tubal carcinomas, and 115 ovarian tumors were investigated by immunohistochemistry. CA 125 and CA 19-9 were demonstrated with monoclonal antibodies, CEA with polyclonal antibodies. The tissue expression was visualized by the avidin-biotin method. In the germinal epithelium of all ovaries no tumor marker was confirmed. In 4 out of 11 tubes the epithelium was CA 125 positive, in 2 out of 11 cases CA 19-9 positive. Nine out of 13 tubo-ovarian abscesses were CA 125 and 5 out of 13 were CA 19-9 positive in their epithelium. Elevated serum levels of these markers might be due to expression via the epithelial cell of the inflamed tube. All normal and inflammatory adnexal tissues were CEA negative. In serous tumors and undifferentiated carcinomas, CA 125 was most frequently confirmed (85 and 70%, respectively). All mucinous tumors were CA 125 negative. The most frequently confirmed tumor marker was CA 19-9 (77%). In endometrioid tumors, CEA was most frequent (44%). In 42% of the borderline tumors and carcinomas only one marker was demonstrated, in 7% none. Here, immunohistochemistry may indicate the most adequate marker. Tumor marker expression was markedly heterogenous: tumor areas with strong, weak, and no reaction were adjacent. The tumor markers revealed no specificity for malignancy or disease.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1989

Mesodermal mixed tumor primary in the fallopian tube.

Mullerian mixed tumors, as a group, are uncommon. Only 27 cases of this tumor of the fallopian tube have been reported to date. We report the 28th case of mixed mesodermal tumor, originating in the fallopian tube. A 79-year-old woman had mistaken a bloody vaginal discharge for hematuria. Various examinations showed no evidence of malignancy. However, computerized tomography revealed an intrapelvic tumor. Laparotomy was performed, with a suspicion of tubal malignancy. The final pathologic diagnosis was mixed mesodermal tumor, originating in the fallopian tube. Postoperatively, the patient was placed on oral adjuvant chemotherapy for 34 months. At present, she is doing well. Though no definite conclusions regarding the best method of therapy can be reached, an aggressive mode of therapy is recommended. The primary therapy is surgery; however, surgery followed by chemotherapy may have a potential benefit.

Aged↗
PubMed1989

Carcinoma of the fallopian tube: clinical management.

From 1970 to 1986, 36 women were diagnosed to have primary fallopian tube cancer. Fifty-three percent of the patients were Stage III with a median adjusted survival of 27 months. Although varied adjunctive therapies were employed, none provided a clear survival benefit. Five "second-look" procedures were performed. Only one was negative, occurring in a Stage IIIC patient treated with combination chemotherapy. She has continued without evidence of disease 26 months following diagnosis. Recurrent disease was uniformly fatal, despite efforts at salvage therapy. Disease biology and response to therapy parallels that of similar stage epithelial carcinoma of the ovary.

Adult↗
PubMed1989

Carcinosarcoma of the fallopian tube.

A patient with Stage III fallopian tube carcinosarcoma treated with cisplatin, doxorubicin, and cyclophosphamide, surviving 31 months disease-free after diagnosis, is presented. Review of the literature revealed this is the 28th case report of malignant mixed Mullerian tumor of the fallopian tube, and fifth instance in which chemotherapy was used as a primary therapy. Modern chemotherapy appears to have improved survival.

Aged↗
PubMed1990

Tumor-associated trypsin inhibitor and cancer antigen 125 in pelvic masses.

Tumor-associated trypsin inhibitor (TATI) and cancer antigen 125 (CA-125) were measured pre- and peroperatively in 183 patients with a pelvic mass to elucidate the value of TATI alone and in combination with CA-125 as a differential diagnostic tool. Malignant tumors were registered in 109 patients (90 ovarian and 19 nonovarian cases), borderline ovarian tumors in 8, and benign tumors in 66 (50 ovarian and 16 nonovarian). The TATI level was increased only in half of the patients with malignant tumors; therefore, the marker cannot be used alone as a preoperative diagnostic tool. In contrast, CA-125 had a sensitivity of 82%, which rose to 91% when the marker was used in combination with TATI. CA-125 and TATI had a combined specificity of 76% and positive and negative predictive values of 87 and 83%, respectively. Our results indicate that TATI measurement substantially improves the preoperative differential diagnostic information obtained with CA-125 and that it does not significantly increase the number of false-positive findings. We recommend the complementary measurement of TATI in patients who have a pelvic mass and a normal CA-125 level.

Adenoma↗
PubMed1990

Serial measurement of CA 125 in patients with primary carcinoma of the fallopian tube.

Serial assay of serum CA 125 was carried out in five patients with advanced primary carcinoma of the fallopian tube. Pretreatmental levels of these patients were elevated, ranging from 145 to 535 U/ml (305 +/- 140.1, mean +/- SD). All patients showed rapid decreases in response to treatment; however, reelevations were noted in two patients concomitant with recurrence. In the remaining three patients, who are alive with no evidence of recurrence at 52, 29, and 21 months, serum CA 125 levels remained below 5 U/ml after remission. These results suggest that CA 125 is useful in monitoring patients with primary carcinoma of the fallopian tube.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1991

Combination chemotherapy in advanced adenocarcinoma of the fallopian tube.

Advanced adenocarcinoma of the fallopian tube has a poor prognosis, with 5-year survival rates commonly less than 20%. Since 1980, we have managed 12 patients with disseminated tumor with combination chemotherapy following surgical cytoreduction. Analogous to the International Federation of Gynecology and Obstetrics staging of ovarian carcinoma, 3 patients were classified in Stage II, 8 in Stage III, and 1 in Stage IV. Ten patients received cisplatin-containing regimens. The 3 Stage II patients, without measurable disease after primary surgery, had an indeterminate response to chemotherapy. In Stages III-IV there were 4 complete responses (3 confirmed by second-look laparotomy) and 2 partial responses, for an overall response rate of 67%. Disease progressed in 2 patients and was stable in 1 patient. After median follow-up of 3.5 years, 4 of the Stage III-IV patients have no evidence of disease, 1 is alive with disease, and 4 are dead.

Adenocarcinoma↗
PubMed1991

Cisplatin-based combination chemotherapy in carcinoma of the fallopian tube.

Forty-three cases of primary tubal adenocarcinoma were treated at Memorial Sloan-Kettering Cancer Center between 1979 and 1989. Thirty-eight patients who received cisplatin-based combination chemotherapy following primary surgery were reviewed. The mean patient age was 59 years, with 86% postmenopausal. Distribution by stage was as follows: I, 3 (7%); II, 4 (11%); III, 27 (71%); and IV, 4 (11%). Median follow-up from the time of diagnosis was 62 months (range, 5-132). Overall survival for all 38 patients by Kaplan-Meier analysis was 51% at 5 years. Excluding stage I, patients with no residual disease following surgery had a significantly higher 5-year survival (83%) than those left with gross residual disease (28%). Twenty-six patients underwent a second-look procedure. Of the 21 patients with advanced (stages III, IV) disease undergoing reexploration, 11 (52%) had a negative second-look and 10 (48%) were positive. Ten of the eleven patients with a negative second-look remain clinically free of disease with a median follow-up of 49 months. One patient with stage III disease had recurred after 47 months. Carcinoma of the fallopian tube appears to respond favorably to cisplatin-based multiagent chemotherapy. Patients with advanced-stage disease who achieve a negative second-look appear to have an improved possibility of remaining disease-free over similar-stage patients with ovarian cancer.

Adult↗
PubMed1992

Malignant mixed Müllerian tumor of the fallopian tube: report of two cases and review of literature.

Malignant mixed Müllerian tumors are usually found in the endometrium, vagina, cervix, and ovary. It is extremely rare for this tumor to arise in the fallopian tube, and to date only 37 tubal cases have been reported. We recently experienced 2 such cases. The clinical features, pathologic findings, diagnosis, therapy, and outcome of these 39 cases were reviewed. The clinical features and diagnosis were similar to those of primary carcinoma of the fallopian tube. Correct preoperative diagnosis was difficult. Histologically, 18 patients had homologous elements and 21 had heterologous elements in the sarcomatous components. The most common type of heterologous element was cartilage, followed by striated muscle and bone. The clinical stage (FIGO staging of ovarian carcinoma) was stage I in 15 cases, stage II in 11 cases, stage III in 8 cases, stage IV in 3 cases, and unknown in 2 cases. In all the patients except 1, the tumor was surgically removed. Postoperatively, radiotherapy was given to 9 patients, chemotherapy to 9 patients, and both to 2 patients. Sixteen patients died of the disease, after a mean period of 16.1 months. Of the 15 stage I patients, 10 survived more than 12 months. The most important prognostic factor was spread of the tumor at diagnosis.

Adolescent↗
PubMed1992

Positive peritoneal cytology is an adverse factor in endometrial carcinoma only if there is other evidence of extrauterine disease.

The prognostic significance of peritoneal cytology among 269 women with clinical stage I and II carcinoma of the endometrium was studied. All patients were surgically staged and had undergone selective pelvic and para-aortic lymphadenectomies. Patients with clear cell and papillary serous carcinomas were excluded from the analysis. Thirty-four (12.6%) patients had malignant cells in the peritoneal washings (positive peritoneal cytology). The effect of positive peritoneal cytology on survival depended upon the extent of disease present. If the disease was confined to the uterus, positive peritoneal cytology did not influence survival; if the disease had spread to the adnexa, lymph nodes, or peritoneum, positive peritoneal cytology had a significant adverse effect on survival, decreasing it at 5 years from 73 to 13%, all recurrences being at distant sites. These findings suggest that treatment specifically directed at positive peritoneal cytology is not warranted unless extrauterine disease is present, and when it is, systemic rather than intra-abdominal treatment will be required to affect survival.

Adenocarcinoma↗
PubMed1987

Cyclophosphamide, hexamethylmelamine, adriamycin and cisplatin combination chemotherapy in mixed mesodermal sarcoma of the female genital tract.

Clinically mixed mesodermal sarcoma is a different entity among the other subtypes of soft tissue sarcomas. Although adriamycin is considered to be the most active single agent in the treatment of adult soft tissue sarcomas, the drug has only limited activity in mixed mesodermal sarcomas. On the other hand, cisplatin is inactive in soft tissue sarcomas, but was reported to be active in mixed mesodermal sarcomas. Therefore combinations including both adriamycin and cisplatin appear attractive for testing in the treatment of mixed mesodermal sarcomas. We have performed a pilot study with two combinations in mixed mesodermal sarcomas of the female genital tract. Two patients treated with adriamycin and cisplatin showed rapid progression. Of 7 patients treated with cyclophosphamide, hexamethylmelamine, adriamycin and cisplatin (CHAP-5), 6 had measurable disease, of whom 5 yielded a response (2 complete responses for 19+ and 40 months and 3 partial responses for 4, 7 and 8 months). The patient with non-measurable disease had a progression-free survival of 27 months. The median survival for all CHAP-5-treated patients was 20 months. This regimen is recommended for further phase II studies.

Aged↗
PubMed1985

Mandibular metastasis from a primary adenocarcinoma of the fallopian tube.

A case of a metastatic lesion to the mandible from a Fallopian tube carcinoma is reported. The presenting symptoms were altered lip sensation and an intraoral mass. A previous history of pelvic infection was reported, but later a diagnosis of adenocarcinoma of the left Fallopian tube was made. Metastatic spread also involved other bones and the liver. No previous case of a metastatic lesion to the oral cavity from the Fallopian tubes has been reported.

Adenocarcinoma↗