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Results for “Fallopian Tube Neoplasms”

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PubMed1994

Primary carcinoma of the fallopian tube: a 20-year literature review.

Case series and important case reports of primary fallopian tube carcinoma published in the English literature from 1973 to 1992 are reviewed. Meta-analysis revealed a mean age of presentation of 56.7 years, with a nulliparity rate of 27.5 per cent and a mean parity of 1.7. Abnormal vaginal bleeding and discharge, and pelvic pain are the most common presenting symptoms. Despite developments in cytology, transvaginal ultrasound, and tumor markers, most cases remain undiagnosed preoperatively. In addition to direct intraperitoneal spread, early lymphatic spread is now recognized as a frequent cause of treatment failure. FIGO has recently released a staging classification for fallopian tube malignancy incorporating detailed surgical staging, which should allow uniformity and comparison between future series. Treatment regimes are empirically based on therapy for epithelial ovarian malignancy, but none have been subjected to controlled trials. Recent case series support extensive debulking surgery and adjuvant platinum-based combination chemotherapy for optimizing prognosis, although results from radiotherapy and hormonal therapy are largely disappointing. Promise is expressed in tumor markers and "second-look" laparotomy for monitoring disease response and planning management.

Adult↗
PubMed1975

Primary carcinoma of the fallopian tube.

Carcinoma of the fallopian tube is the least common of the gynecologic malignancies. Because of its rarity and the absence of typical symptoms, preoperative diagnosis is seldom made. Patient as well as physician delay in diagnosis is often considerable. There are no reliable laboratory aids available to enhance the discovery of this tumor. However, routine periodic pelvic examinations with laparoscopic examination of any significant adnexal enlargement in postmenopausal women should decrease the discovery time. Certainly, unexplained vaginal discharge or bleeding particularly when associated with a pelvic mass, should increase one's suspicion. Conventional surgical treatment can be curative if the tumor has not exceeded the confines of the tube and has not involved the serosa. Regardless, the prognosis for patients with primary carcinoma of the fallopian tube is grim.

Adenocarcinoma↗
PubMed1985

Multicentric müllerian squamous neoplasia.

Pure squamous neoplasia of the uterine corpus and uterine tube is explained by two possible mechanisms termed horizontal spread and vertical proliferation. We have reported a case of epidermoid carcinoma in situ of the uterine tube exemplifying the latter.

Carcinoma in Situ↗
PubMed1991

Recurrent adnexal torsion and cystadenoma of aberrant ovarian tissue.

Torsion of the adnexa is rare, and diagnosis is difficult because of the sparse clinical findings. I describe a patient with recurrent torsion of the right adnexa, involving a cystadenoma of aberrant ovarian tissue. Her only symptom was recurrent right-sided pelvic pain.

Adnexal Diseases↗
PubMed1996

The clinical significance of calculated versus measured creatinine clearance in patients with gynecologic malignancy.

Measurement of creatinine clearance remains in convenient because of the need for 24-hour urine collection. Our study compared creatinine clearance calculated from serum creatinine (CC alpha) to measured creatinine clearance (MC alpha) using an unsupervised 8-hour urine collection at home. Forty-two women admitted to our gynecologic oncology service participated in this study. Twenty-six of these patients had cancer originating from the ovaries, 8 from the uterus, 7 from the cervix, and 1 from the fallopian tube. There were adequate data for 61 collections. MC alpha using unsupervised 8-hour urine collection at home correlated well with CC alpha. This calculated value may be sufficient to be used as a guide in evaluating renal function in patients with gynecologic malignancy. However, if it becomes necessary to measure creatinine clearance, our data suggest that an 8-hour collection may be used.

Age Factors↗
PubMed1999

Hydrosalpinx due to asymptomatic bilateral tubal pregnancies associated with metaplastic papillary tumor of the fallopian tube.

The patient described in this report had bilateral hydrosalpinx due to pregnancies in both fallopian tubes, treated by laparoscopic resection. Histologically, both fallopian tubes revealed intratubal occlusion by degenerated, partially calcified chorionic tissue. An incidental finding was an intraluminal papillary epithelial tumor in one of the fallopian tubes. The clinical significance and complications of asymptomatic tubal ectopic pregnancy and the pathogenesis and biologic behavior of papillary epithelial tumors of the fallopian tube are briefly discussed.

Calcinosis↗
PubMed2004

Sonographic diagnosis of primary malignant tumors of the fallopian tube.

The purpose of this study is to illustrate the sonographic features of primary malignant tumors of the fallopian tube and to heighten awareness of their existence. This is a retrospective review of the imaging and clinical files of 7 patients with a primary malignant tumor of the fallopian tube found in the medical records of 4500 patients with primary gynecologic malignancies seen during the last 6 years at the authors' institution. All patients had transvaginal sonography before surgery. Images were reviewed to determine common features of this rarely encountered pathology. Transvaginal sonography showed normal ovaries in 5 patients in association with a discrete solid adnexal mass in 4. The fallopian tube origin of the mass was shown directly in 2 of these 4 patients and was inferred in the other 2 on the basis of a mass in the expected location of the fallopian tube. In the 3 patients without a discrete adnexal mass, there were more extensive changes, including large, solid adnexal masses of unknown origin (n = 2) and gross peritoneal carcinomatosis (n = 1). Fallopian tube malignancies should be considered when unexplained solid masses corresponding with the expected location of the fallopian tubes are seen in association with normal ovaries. Disease dissemination may show carcinomatosis or more extensive pelvic disease.

Diagnosis, Differential↗
PubMed2005

BRCA-mutation-associated fallopian tube carcinoma: a distinct clinical phenotype?

OBJECTIVE: To compare clinical and histologic features between fallopian tube cancers in women with germline BRCA mutations and sporadic cases. METHODS: Twenty-eight patients with fallopian tube cancer had BRCA mutation testing using multiplex polymerase chain reaction and protein truncation testing. Histologic slides were reviewed by 2 pathologists, and immunohistochemical staining for p53, ki67, estrogen receptor, and progesterone receptor was performed on carcinomas and dysplastic and benign tubal epithelia. RESULTS: Twelve of 28 (43%) women had BRCA mutations: 11 BRCA1, 1 BRCA2. Excluding 4 cases found at prophylactic surgery, the median age of diagnosis of BRCA mutation carriers was 57 years compared with 65 years among sporadic cases (P = .09). Patients with BRCA-associated fallopian tube cancer had a median survival time of 68 months compared with 37 months when compared with sporadic cases (P = .14). Both groups had predominantly advanced stage, high grade, serous fallopian tube cancers. No patient had exclusively proximal disease. Occult fallopian tube cancer diagnosed at prophylactic surgery in BRCA mutation carriers was exclusively distal. "Skip" areas of high-grade dysplasia were only seen in 2 patients, both of whom were BRCA mutation carriers. There were no differences in the immunohistochemical staining for p53, ki67, estrogen receptor or progesterone receptor in carcinomas and dysplastic or benign epithelia of patients with or without BRCA mutations. Overexpression of p53 was commonly seen in fallopian tube cancers and dysplastic epithelium, but rarely noted in benign epithelium. CONCLUSION: Fallopian tube cancer is part of the BRCA mutation phenotype and seems to share many clinical features with sporadic fallopian tube cancers, including no exclusively proximal disease. The presentation of BRCA-associated fallopian tube cancers may, however, occur at a younger age and have an improved survival.

Adult↗
PubMed2005

Primary fallopian tube carcinoma.

UNLABELLED: Primary fallopian tube cancer constitutes 1% of gynecologic malignancies. Early clinical manifestation and prompt investigations lead to diagnosis in the early stage of disease accounting for a better survival compared with ovarian cancer. Principles of management generally follow that of epithelial ovarian cancer. This article reviews the current understanding of this rare cancer. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians. LEARNING OBJECTIVES: After completion of this article, the reader should be able to describe the clinical features of a patient with fallopian tube carcinoma, to list the prognostic factors associated with fallopian tube cancer, and to outline the treatment options for a patient with fallopian tube cancer.

Chemotherapy, Adjuvant↗
PubMed2004

Endometrioid carcinoma of the fallopian tube resembling a female adnexal tumor of probable wolffian origin.

Endometrioid carcinoma of the fallopian tube resembling a female adnexal tumor of probable wolffian origin (FATWO) is a rare, recently delineated, low-grade carcinoma that may be confused with both FATWO and high-grade carcinoma. Only about 20 cases have been reported so far, but it probably represents almost half of the endometrioid carcinomas of the fallopian tube. It has a better prognosis than conventional tubal endometrioid and serous carcinomas. Macroscopically, the tumors form a small, solid, polypoid mass that is usually confined within the tube. Microscopically, the tumors are characterized by proliferations of spindle cells in whorls and closely packed confluent elongated glands with focal tubular, sieve-like, and papillary structures. Unlike FATWO, this variant of endometrioid carcinoma exhibits focal squamous differentiation, intraluminal mucin, mild to moderate nuclear atypia, and occasional mitosis. Unlike FATWO, tumor cells are negative for inhibin-alpha and calretinin.

Carcinoma, Endometrioid↗
PubMed2004

Serous carcinoma of the ovary, fallopian tube, or peritoneum presenting as lymphadenopathy.

The clinicopathologic features of 35 cases of serous carcinoma of the ovary, fallopian tube, or peritoneum presenting as lymphadenopathy are described. The cases were retrieved from the files of the Department of Pathology at the University of Texas M. D. Anderson Cancer Center from a 20-year period (1982-2002). The following parameters were evaluated: patient age at diagnosis, lymph node involved, primary tumor site, tumor histology, peritoneal disease status, and survival. The patients ranged in age from 30 to 85 years (mean, 59 years). The lymph nodes involved were inguinal, 20 cases; supraclavicular, 11 cases; axillary, 2 cases; cervical, 1 case; and retroperitoneal, 1 case. Primary tumor sites included 20 ovarian, 10 peritoneal, and 2 fallopian tube. In 2 patients, total abdominal hysterectomy/bilateral salpingo-oophorectomy and complete staging showed no additional tumor, and in 1 patient with a previous history of total abdominal hysterectomy/bilateral salpingo-oophorectomy for a benign condition, imaging studies did not identify a primary site. The carcinoma was high grade in 30 cases and low grade in 4 cases. In one case, the diagnosis was made on cytology material and the tumor could not be graded. Peritoneal disease status was known in 33 patients and was as follows: omentum with gross disease, 16 cases; and omentum without gross disease, 17 cases. Follow-up was available in 33 patients and ranged from 4 to 204 months, with a median survival of 36 months for stage III patients and 29 months for stage IV patients. Patients with adenopathy and minimal peritoneal disease (grossly negative omentum) had a median survival of 120 months compared with 24 months for those with bulky peritoneal disease (grossly positive omentum). Serous carcinoma of the ovary, fallopian tube, or peritoneum presenting as a lymph node metastasis is uncommon. In rare cases, a primary site may not be found. The median survival of the patients for stage is not appreciably different from those patients presenting in the usual fashion, suggesting that this atypical presentation does not adversely affect survival. Patients with minimal peritoneal disease and extra-abdominal lymph node metastases survive longer than those with bulky peritoneal disease

Adult↗
PubMed2006

The tubal fimbria is a preferred site for early adenocarcinoma in women with familial ovarian cancer syndrome.

A proportion of adenocarcinomas in prophylactic adnexectomies (bilateral salpingo-oophorectomies [BSOs]) from women with BRCA mutations (BRCA positive) occur in the fallopian tube. We analyzed a consecutive series of BSOs from BRCA-positive women following an index case of fimbrial serous carcinoma. To determine if the fimbria is a preferred site of origin, we followed a protocol for Sectioning and Extensively Examining the FIMbria (SEE-FIM). Immunostaining for p53 and Ki-67 was also performed. Thirteen BRCA-positive women (cases) and 13 women undergoing BSOs for other disorders (controls) were studied. Tubal carcinoma was detected in 4 cases at the initial histologic evaluation and in no controls. A fifth carcinoma was discovered following further sectioning of the fimbriae. Three were BRCA2 positive and two BRCA1 positive. Three were in the fimbria, one in both the fimbria and proximal tube, and one involved the ampulla. Four were serous carcinomas, four were confined to the tube, and three were noninvasive (intraepithelial). No ovarian carcinomas were identified. All tumors were Ki-67 positive (>75% of cell nuclei), and excluding one endometrioid carcinoma, p53 positive (>75% cell nuclei); p53 positivity in the absence of elevated Ki-67 did not correlate with morphologic neoplasia. The fimbria was the most common location for early serous carcinoma in this series of BRCA-positive women. Protocols that extensively examine the fimbria (SEE-FIM) will maximize the detection of early tubal epithelial carcinoma in patients at risk for ovarian cancer. Investigative strategies targeting the fimbriated end of the fallopian tube should further define its role in the pathogenesis of familial and sporadic ovarian serous carcinomas.

Adenocarcinoma↗
PubMed2003

Extrauterine lesions of intermediate trophoblast.

Lesions of intermediate trophoblast arising in the uterus include exaggerated placental site, placental site nodule, placental site trophoblastic tumor (PSTT), and epithelioid trophoblastic tumor. Only 12 examples of extrauterine lesions of intermediate trophoblast (ELIT) have been previously reported; 7 new cases are described herein. Six lesions were located in the fallopian tube or paratubal region and one in the ovary. The patients were 25 to 47 (average 36) years of age. The lesions ranged from 0.6 to 4 cm in diameter; four were cystic. The four placental site nodules (three tubal, one paratubal) were composed of small, sharply circumscribed nodules of intermediate trophoblast with no mitotic activity. The three PSTTs (two tubal, one ovarian) exhibited irregular stromal infiltration by intermediate trophoblast, mitotic activity, and necrosis. Chronic salpingitis was seen in the six tubal/paratubal cases, and endometriosis was seen in four cases. Immunoreactivity for human placental lactogen, human chorionic gonadotropin, and cytokeratin in two cases was consistent with an origin from intermediate trophoblast. ELITs presumably arise from previous ectopic pregnancies, a history of which was present in two of these patients. Follow-up, available on two of the three patients with PSTT, was uneventful at 6 and 12 years, but study of additional cases is necessary to reliably determine the behavior of extrauterine PSTTs.

Adult↗
PubMed2003

Serous tumor of low malignant potential arising in inguinal endosalpingiosis: report of a case.

A 46-year-old woman presented with a right inguinal mass. Imaging studies revealed no abnormalities of the pelvis (including the ovaries) or abdomen. The inguinal mass was composed predominantly of variably sized cysts lined by flat to low cuboidal cells resembling mesothelial cells and ciliated columnar tubal-type cells with a focal transition between the two cell types. Papillae, detached cell clusters with mild cytologic atypia, and psammoma bodies were also found, warranting a diagnosis of a serous borderline tumor. This appears to be the first report of a serous borderline tumor arising in inguinal endosalpingiosis and not associated with an ovarian serous tumor.

Cystadenocarcinoma, Serous↗
PubMed2004

Spindle cell ossifying amyloidotic tumor of the fallopian tube.

We report a unique tumor of the fallopian tube that was an incidental finding in a 60-year-old woman. The tumor was characterized by nests of spindle cells embedded in a partially ossified, hyalinized stroma, that also contained amyloid and basement membrane-like material. The histologic appearance of the tumor cells suggested an epithelial nature, but no immunohistochemical or ultrastructural evidence of such was found. The circumscription of the tumor and its lack of mitotic activity and cytologic atypia suggest a benign nature, but the histogenesis and appropriate classification of the tumor remain unclear.

Amyloid↗