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Results for “Fallopian Tube Neoplasms”

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PubMed1977

Postmenopausal gyn problems.

The conservative use of estrogens for prevention and treatment of osteoporosis is discussed. The author stresses the importance of thorough pelvic examination to detect inflammatory processes, possible generative tract prolapses, and/or growths.

Estrogens↗
PubMed1995

Cytoreduction of small intestine metastases using the Cavitron Ultrasonic Surgical Aspirator.

The Cavitron Ultrasonic Surgical Aspirator was used to reduce the volume of the small intestine metastases in 37 patients. Thirty-four patients had epithelial carcinoma of the ovary, and one each had tubal adenocarcinoma, papillary peritoneal tumor, and mesothelioma. Thirty-one patients had stage IIIC disease, and six had stage IV. Initially, 18 patients had small bowel disease greater than 15 mm in diameter (of any single nodule), and 10 had disease 6-15 mm in diameter. After cytoreduction using standard means, 18 patients had disease greater than 15 mm in diameter, and 9 patients had disease 6-15 mm in greatest diameter. After using the Cavitron, 13 patients had no gross residual disease, and 24 patients had disease 1-5 mm in diameter. The Cavitron Ultrasonic Surgical Aspirator is invaluable to obtain minimal residual disease of small bowel metastases while avoiding intestinal resection.

Adenocarcinoma↗
PubMed1981

Bilateral papillary adenofibroma of the fallopian tube.

A unique case of bilateral papillary adenofibroma of the fallopian tube is reported. The seven-year disease-free follow-up after simple excision without salpingectomy further confirms the benign nature of this entity.

Adenofibroma↗
PubMed1991

Sex cord tumor with annular tubules associated with endometriosis of the fallopian tube.

Sex cord tumor with annular tubules (SCTAT) is a distinctive ovarian sex cord-stromal tumor. The authors describe a case of SCTAT arising outside the ovaries, in the fallopian tube. The authors are aware of only one other case of extra-ovarian SCTAT, in an umbilical hernia sac in an adult woman. The case reported was an incidental finding in a hysterectomy specimen, obtained because of carcinoma in situ of the uterine cervix in a 32-year-old woman. The patient is alive and disease-free two years after surgery. The 1-cm tumor in the right fallopian tube was composed of typical ring-shaped tubules encircling hyalinized basement membrane-like material. In addition, glands and stroma of endometriosis were intimately admixed with the nests of tumor. The implications of these findings for the origin of SCTAT and ovarian sex cord structures are discussed.

Adult↗
PubMed1996

Primary carcinoma of the fallopian tube. A retrospective analysis of 47 patients.

BACKGROUND: Fallopian tube carcinoma is a rare disease, and few data about prognostic factors are available in the literature. PATIENTS AND METHODS: The medical charts of 47 patients with primary carcinoma of the fallopian tube treated at our institution between 1982 and 1994 were reviewed. Age, stage, histologic grade, residual disease after surgery, peritoneal cytology and lymph-node involvement were evaluated for their prognostic impact in a univariate analysis. RESULTS: The mean age of the patients was 57.5 years and 19 of them (40%) had early-stage disease. Poorly differentiated tumors were diagnosed in 64% of the patients. Eleven of 20 patients (55%) submitted to surgical evaluation of lymph nodes had retroperitoneal involvement. Thirty-three patients received CAP chemotherapy following surgery, and the overall clinical response rate was 80%. Sixteen patients (34%) had recurrences within 8 to 50 months from diagnosis. Twenty patients (42.6%) are alive without disease, one patient is alive with tumor, and 26 patients (55.3%) died of the disease. The median survival for the group as a whole was 44 months, and the actuarial 5-year survival was 29%. In univariate analysis stage (I + II vs. III + IV), grade (G1 + G2 vs. G3) residual disease after surgery (less than 2 cm vs. greater than 2 cm). peritoneal cytology (negative vs. positive) and lymph-node metastases were all factors significantly affecting survival. CONCLUSIONS: Aggressive cytoreductive surgery followed by platin-based chemotherapy offer the possibility of long-term control of primary tubal carcinoma.

Adult↗
PubMed1996

Ovarian tissue cryopreservation for patients.

For patients about to receive chemotherapy, radiotherapy or to undergo a surgical procedure, loss or impairment of fertility is a major issue. For males, sperm banking is a standard accepted procedure to circumvent loss or damage to spermatozoa and this has been undertaken in this unit since 1975 (Steele et al., 1995). For women there is no established procedure for gamete storage. Embryo preservation is not an option for single women or even for those in a stable relationship, as treatment would have to be delayed while ovarian stimulation and oocyte retrieval took place. With the general shortage of donor oocytes, the possibility of maturing primordial follicles from fetal ovaries has become a subject for debate (HFEA 1995: Recent deliberations). In animals, the use of frozen ovarian tissue has been encouraging with a report of a live birth in lamb after orthotopic transplantation (Gosden et al., 1995). Media attention to the future prospect for freezing ovarian tissue has meant that pressure from patients is likely to increase either for information or as requests to freeze the ovarian tissue which could irretrievably be lost as a result of surgery and/or treatment. In the absence of well defined procedures and technologies, should women be given the chance to preserve ovarian tissue prior to receiving intensive chemotherapy or radiotherapy?

Adult↗
PubMed1987

Tubo-cornual polyps: their relevance in subfertility.

One-hundred-and-seventy-four patients having hysterosalpingographs during the investigation of infertility have been reviewed to assess the incidence of tubo-cornual polyps and their relation to subsequent pregnancy. Definite polyps were present in 31 (18%) of the patients. There was no significant difference in age or parity in women with and without polyps, nor in associated infertility factors such as tubal occlusion or oligospermia. None of the patients with polyps had endometriosis. Conception rates in the two groups were not significantly different. The cumulative rates at 18 months with and without polyps were 34.5 +/- 13.7% (SE) and 43.6% +/- 3.9% respectively in the overall groups, and 36.9% +/- 24.1% and 59.0% +/- 9.1% in the couples with otherwise unexplained infertility. It is concluded that tubo-cornual polyps are not related to infertility and that they should not be treated.

Adult↗
PubMed1993

Histological findings in a falloposcopically retrieved isthmic plug causing reversible proximal tubal obstruction.

We present the case of a 33-year-old woman with a 10 year history of infertility. Transvaginal falloposcopy revealed a proximal tubal occlusion (PTO) on the right due to a tissue plug. The plug was removed during dilatation of the tubal lumen. After the procedure patency for dye was restored. Histological and immunohistochemical findings--for the first time, to the best of our knowledge, performed in a falloposcopically retrieved plug--revealed the diagnosis of an inflammatory polyp arising from the tubal mucosa with focal calcifications. Local obstructive inflammatory residues of a previously treated tubal endometriosis, which was accompanied by features of salpingitis isthmica nodosa, are considered the most likely cause for this condition. Other possible aetiological factors responsible for PTO are discussed.

Adult↗
PubMed1986

Treatment of carcinoma of the fallopian tube using cisplatin, doxorubicin, and cyclophosphamide.

Nine patients with metastatic carcinoma of the fallopian tube were treated with a combination of cisplatin, doxorubicin, and cyclophosphamide. Three are in complete clinical remission following surgically documented complete response, at 18-56 months following the onset of chemotherapy. Two others died of intercurrent causes without evidence of disease. The remaining four died of tumor at 12, 23, 28, and 52 months following the initiation of treatment. Four second-look laparotomies were performed upon patients who were in complete clinical remission. No disease was found in any of these patients. It is concluded that this combination is an effective treatment for adenocarcinoma of the fallopian tube, and that second-look laparotomy may be useful in assessing response to chemotherapy in this disease.

Aged↗
PubMed1994

Treatment of primary fallopian tube carcinoma with cisplatin-containing chemotherapy.

Because of the rarity of the primary fallopian tube carcinoma, optimal primary therapy is still not well defined, and there is little information available regarding the efficacy of combination chemotherapy in advanced disease. The experience obtained by treating 14 patients with fallopian tube carcinoma--most of them with advanced disease--using a combination of cisplatin, adriamycin, and cyclophosphamide (CAP) (10 patients) or carboplatin plus cyclophosphamide (4 patients) is reported. One patient had Stage Ic disease, 2 had Stage II, 9 had Stage III, and 2 had Stage IV. Eleven patients had clinically measurable disease (> 2 cm) at the start of chemotherapy. Eight of these patients had a complete clinical response (CR), 2 had partial response (PR), and 1 had progressive disease (PD). Of the 8 CR patients, 5 underwent second-look operation (SLO). Pathological complete response (pCR) confirmed in 4 out of 5 patients at SLO. The 3 patients without measurable disease (< 2 cm) after primary surgery had an indeterminate response to chemotherapy. Two of them (Stages Ic and II, respectively) had a negative SLO, while the third patient with Stage IV disease, who refused the SLO, remains disease-free 41+ months. This high response rate shows that this carcinoma is very responsive to cisplatin- or cisplatin analogue-containing regimens. One pCR and two clinical CR patients relapsed after 20, 14, and 16 months, respectively, from the completion of chemotherapy and died despite the second-line treatment. The toxicity of the regimens was moderate. The median survival was 40 months, and the actuarial 5-year survival rate was 48%. Carcinoma of the fallopian tube appears to respond favorably to cisplatin- or carboplatin-containing chemotherapy.

Adenocarcinoma↗
PubMed1997

Treatment of fallopian tube carcinoma with cyclophosphamide, adriamycin, and cisplatin.

Primary carcinoma of the fallopian tube is uncommon; optimal primary treatment is still not well defined, and little information is available about the efficacy of cisplatin-based combination chemotherapy. Thirty-eight patients with fallopian tube carcinoma were treated with cyclophosphamide (500 mg/m2), Adriamycin (50 mg/m2), and cisplatin (50 mg/m2) (CAP). Thirty-two patients received the combination chemotherapy as first-line treatment after cytoreductive surgery, whereas six subjects were treated for recurrent disease. The patients received a median of six cycles of therapy (range, four to nine). At the initiation of chemotherapy, 24 patients had measurable lesions. In this group of patients, 15 had a clinical complete response (CR), four had a partial response (PR), three had stable disease (SD), and two had progressive disease (PD) after chemotherapy. The overall clinical response rate (CR + PR) was 80%. Ten of the 14 CR patients who were submitted to second-look operation (SLO) were found free of disease, in pathologic complete response (pCR). Three pCR patients relapsed, and two of them died despite second-line treatment. Nine patients achieving PR, SD, and PD after first-line chemotherapy were further treated (five with chemotherapy, two with radiotherapy, two with progesteron), but none responded to second-line treatment and all died (median survival, 9 months). Fourteen patients without gross residual disease after cytoreductive surgery had no measurable lesions and were not evaluable for response. Seven of them had negative SLO and remain disease free. Three patients (two stage III and one stage II) who refused SLO relapsed 14, 16, and 26 months after completion of chemotherapy. The median survival for the entire group was 38 months, and the 5-year survival rate was 35%. The toxicity of the regimen was moderate. The CAP regimen appears to be active in primary fallopian tube carcinoma and yields response rates comparable to those reported for epithelial ovarian cancer.

Adult↗
PubMed1999

Gemcitabine salvage chemotherapy for patients with gynecologic malignancies of the ovary, fallopian tube, and peritoneum.

The efficacy and toxicity of gemcitabine salvage chemotherapy was evaluated in 27 heavily pretreated patients with recurrent and progressive ovarian, fallopian tube, or peritoneal cancer. At least one platinum-based chemotherapeutic regimen had failed in each patient. The median number of previous chemotherapy regimens and cycles of chemotherapy was 4 and 23, respectively. A total of 124 cycles of gemcitabine were delivered (median, 3 cycles). Hematologic toxicity included four patients with grade 3/4 thrombocytopenia and two patients with grade 3/4 neutropenia. Thrombocytopenia and neutropenia resulted in eight dose reductions and a single 1-week treatment delay. Nonhematologic side effects were well tolerated and largely self-limiting. No complete responses were observed. Three patients (11%) demonstrated partial responses to therapy. The duration of response was 7 months for two of the responders and 5 months for the third responder. Stable disease was observed in 14 patients (52%), in whom the median progression-free interval was 5 months. In conclusion, among heavily pretreated patients, gemcitabine has limited antitumor activity in platinum-resistant carcinomas of the ovary, fallopian tube, and peritoneum. The role of gemcitabine in the treatment of gynecologic malignancies of the ovary, fallopian tube, and peritoneum will be determined by studies that define the efficacy of multiagent regimens of chemotherapy that include gemcitabine and by studies that include patients who have been less heavily pretreated.

Adult↗