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Malignant mixed müllerian tumor of the fallopian tube. Case report and review of the literature.

Malignant mixed müllerian tumor of the fallopian tube is extremely rare, with less than 50 cases recorded in the English literature. Another case is reported and discussed. This 66-year-old female patient complained of profuse watery vaginal discharge for one month. Vaginal cytology was positive for malignancy while the endometrial curettage and cervical biopsy were both negative. Gynecologic sonography revealed a left adnexal mass of 6 cm in diameter. She underwent exploratory laparotomy after complete oncologic survey. The main tumor was confined to one tube but the peritoneal washing cytology was positive for adenocarcinoma cells. She tolerated the maximal debulking surgery very well but refused to receive adjuvant chemotherapy. Pathology proved that the tumor was composed of poorly differentiated adenocarcinoma and sarcoma. There were focal areas of rhabdomyoblastic differentiation with cross striation in immunoperoxidase stain. Carcinomatosis peritonii occurred 12 months after primary surgery and she expired one month later.

Aged↗

[Present occurrence of benign teratoma of ovary and fallopian tube in a patient with adnexal torsion].

OBJECTIVE: The authors demonstrate the case of left adnexal torsion caused by 2 benign teratomas in its ovarian and tubal location. DESIGN: Case report. SETTING: Department of Obstetrics and Gynecology, 1st Faculty of Medicine and General Teaching Hospital, Charles University, Prague. CASE: 24-years old woman underwent laparoscopy for several days lasting pain in lower abdomen and ultrasound finding of semicystic mass in the left adnexal region with suspicion of teratoma. The benign teratoma of the left ovary together with a torsion of the left Fallopian tube distended by teratoma was revealed during surgery. Left side salpingectomy and enucleation of the ovarian teratoma has been performed. This surprising finding was confirmed by histopathological examination. CONCLUSION: The acute gynaecological torsion event may be caused not only by torsion of uterine fibroid or enlarged tumorous ovary but rarely also by a teratoma of the Fallopian tube.

Adnexal Diseases↗

Elastin in adenomatoid tumor. Light microscopic and electron microscopic study.

Elastin distribution was examined in adenomatoid tumors of the human genital tract. Two distinct patterns were identified: strongly positive or completely negative for elastin in the stroma, according to the case. Even in cases appearing to have very similar histologic features, the stroma was rich in elastin in some cases and was almost devoid of elastin in others. Electron microscopic examination with tannic acid staining revealed that the elastin in the stroma was composed mainly of amorphous material surrounded by a small amount of microfibrils and abundant collagen fibers. Fibroblasts were sparsely distributed in the stroma. Tumor cells displayed mesothelial cell-like features, such as abundant microvilli on the surface, numerous cytoplasmic organelles, several well-developed basal lamina. In some areas, elastin seemed to be formed by mesothelial cells. In some adenomatoid tumor cases, elastogenesis would be enhanced by activated mesothelial tumor cells as well as stromal fibroblasts.

Elastin↗

A review of fallopian tube carcinoma over 20 years (1971-90) in Pondicherry.

Nine cases of tubal carcinoma were found in a period of 20 years in JIPMER Hospital among approximately 9,000 gynaecological malignancies. Most patients were diagnosed as malignant ovarian tumour, but two cases presented unusually, one as Meig's syndrome and another as acute hemoperitoneum. This often stressed symptom of amber discharge or hydrops tubae profluens could not be elicited in any patient. All the patients underwent surgical treatment and radiotherapy or chemotherapy. The period of follow up ranged from two months to four and half years.

Adult↗

Mature cystic teratoma of the fallopian tube associated with an ectopic pregnancy.

We describe the occurrence of a mature cystic teratoma of the fallopian tube discovered at laparoscopy for an ectopic pregnancy. Only five previous reports of this concurrence have been found in the medical literature. We review the reported cases of tubal teratoma and summarize all cases found with an ectopic tubal pregnancy.

Adult↗

[Endometriosis: indications, operative techniques, results].

Laparoscopic treatment of endometriosis is essential, elegant, efficacious. It is a more complex laparoscopic surgical procedure because of the adnexial lesions, now performed thank's to recent improved instrumentation. At the time of diagnosis, a complete evaluation of lesions appropriately staged according to the American Fertility Society classification scheme is necessary before destruction of endometriotic implants, adhesiolysis and ovarian cystectomy. CO2 videolaseroscopy with laser adhesiolysis and vaporization has been developed with precise destructions of disease tissue and minimal tissue reaction. Laser surgery with complex operative laparoscopy has many advantages: minimal damage of the adjacent normal tissue, minimal ovarian destruction, minimal bleeding and minimal postoperative adhesion formation.

Endometriosis↗

Gestational trophoblastic disease of the fallopian tube.

Tubal gestational trophoblastic disease (GTD) was diagnosed in 16 (0.8%) of 2,100 women with GTD managed at the New England Trophoblastic Disease Center. Tubal partial mole, complete mole and choriocarcinoma were present in 5, 5 and 6 patients, respectively. Patients with tubal GTD were not clinically distinguishable from those with traditional tubal pregnancies. While only one patient with tubal mole developed metastases, four patients with tubal choriocarcinoma presented with metastases. All the patients achieved complete, sustained remission.

Adolescent↗

[Tubo-peritoneal factor. Endometriosis].

Fifty cases of tuboperitoneal endometriosis with sterility, are reviewed. Laparoscopy was done in all the patients to confirm disease, and its severity was classified to AFS; 18 cases were of minimal endometriosis; 8 slight; 12 moderate; and 12 severe. The endometriotic profile in our environment is described and compared with which has been described in progresist countries; 32% of pregnancy at term, was obtained. The possible mechanisms producing sterility, are mentioned.

Adult↗

[Intraperitoneal chemotherapy through implantable injection port in patients with advanced ovarian (or tubal) carcinoma].

A total of 38 cycles of intraperitoneal chemotherapy through implantable injection port were carried out in 9 patients with advanced or recurrent ovarian (tubal) carcinoma. The combination chemotherapy consisted of cisplatin 100 mg or carboplatin 450 mg, 5-FU 500 mg and OK-432 10 KE was administered every four weeks for a total of six cycles. Clinical response was evaluated after chemotherapy. Of the eight evaluated patients (in one patient chemotherapy is not completed yet), 1 had complete response, 3 partial response, 2 stable disease and 2 progressive disease. Therapy-related toxic effects were moderate, consisting chiefly of myelosuppression that seemed dose limiting.

Adult↗

[Endosalpingosis in the pelvic peritoneum and pelvic lymph nodes].

The pelvic peritoneum with macroscopic findings characteristic of endometriosis was biopsied in 18 cases at conservative surgery for endometriosis and examined. Pelvic lymph nodes removed in 76 cases at radical surgery for uterine cervical, corpus cancer or ovarian cancer patients were examined. In 3 of the 18 cases, endosalpingiosis was encountered in the pelvic peritoneum. In 2 of these 3 cases combined lesions of endometriosis and endosalpingiosis were observed. On the other hand, in 4 of the 76 patients with gynecological malignancies, benign glandular inclusions were found in pelvic lymph nodes. In 3 of these 4 patients, there was endosalpingiosis, and another there was endometriosis. Endosalpingiosis is an interesting lesion offering some clues to the histogenesis of endometriosis, and important in the differential diagnosis of malignant tumors.

Adult↗

[Endosalpingosis or microcystic and proliferating glandular inclusion disease of the genital tract and peritoneum. Apropos of 6 cases].

Endosalpingosis, defined by the presence in an ectopic site of epithelium comparable to that of the tubal mucosa, is not a well-known entity. In reference to 6 cases of our department, the authors have been able to assess this lesion. Clinical manifestations and laboratory tests offer no arguments. Cytology represents a diagnostic trap. The diagnosis may only be made histologically and is very often fortuitous. This benign lesion is often the result of a metaplasic process but, considering the difficulty of the diagnosis, the treatment is often surgical (total hysterectomy with castration). The course is uneventful.

Adult↗