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A case is reported of a patient who presented with the clinical diagnosis of a uterine polyp extruded through the cervix. Subsequently, the "polyp" was found to be a Fallopian tube which had been pulled into the uterus through a fundal perforation of curettage performed 10 months previously.
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The endoscopic retroperitoneal approach is a minimally invasive method for surgical staging of cervical cancer. A 57-year-old woman had an intraoperative diagnosis of carcinoma of the left fallopian tube and undergone a retroperitoneal pelvic and para-aortic lymphadenectomy with no peritonization during surgical staging. Small suspicious nodes in the serous membrane of the sigmoid colon and peritoneal washings were positive for malignancy. A total of 12 nodes were obtained, all of which were negative. She received six cycles of paclitaxel and platinum-based chemotherapy and showed a complete clinical response. Thirty-two months after surgery, the abdominal computed tomography scan showed a left para-aortic lymph node, 19 mm in diameter, which was successfully removed through an extraperitoneal laparoscopic approach. The extraperitoneal laparoscopic approach of the para-aortic region is a feasible procedure after previous transperitoneal lymphadenectomy and chemotherapy.
A bilateral salpingectomy was performed at the time of vaginal hysterectomy in a pregnant patient sterilized 20 months earlier by application of Bleier clips to the fallopian tubes. Clip application to the left tube had been incomplete. Undisturbed tissue (left tube) and clipped tissue (right tube) were examined and compared by light and scanning electron microscopy. The segment of tube fully grasped by the clip had a completely detached lining epithelium with coarse and flattened mucosa, a loose stroma, and disorganized muscular bundles. The left tubal mucosa was normal, whereas the right tube was stenosed at the site of clip placement, with rigid walls and a 0.175 mm luminal diameter. With progressively greater stenosis toward the clip site, mucosal destruction increased. Polypoidal mucosal folds were seen, as well as fibrous adhesions between mucosal folds. These observations indicate that tissue damage is extensive enough after clip application to require excision of the damaged segment of tube and microsurgical re-anastomosis for reversal of sterilization.
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The epithelium of the three species of bats studied shows the presence of ciliated and nonciliated cells both in the ovarian and uterine segments of the Fallopian tube of the functional uterine horn. The cytoplasm of these two cells types shows small amount of glycogen during anestrus, the amount increasing during proestrus and estrus. At estrus, the nonciliated cells show the presence of neutral and sialomucins in addition to glycogen in Pteropus giganteus giganteus and Megaderma lyra lyra. The concentration of these mucins was found to decline during pregnancy and parturition. In Taphozous longimanus, the mucins which are located in cytoplasmic projections or domes of the nonciliated cells show the presence of neutral, sialomucins, sulfomucins and glycogen. These mucins which are first seen in the proestrus period increase during estrus. However, during pregnancy, these domes regress concomitant with decline in the mucin content. Glycogen content of the ciliated cells increases during estrus and decreases during pregnancy. Since in all the three species of bats the mucin content is at its maximum at oestrus and shows a decline during pregnancy, it appears that its elaboration and increase is under the influence of estrogen, instead progesterone blocks its generation and brings about its release.
It is postulated that the propagated electric activity of the gut is generated by the interstitial cells of Cajal (ICCs). We investigated the hypothesis of the presence of ICCs in the Fallopian tube (FT) as initiators of the tubal electric activity. Specimens from various parts of the FT were obtained from 21 female cadavers (mean age 38.2 +/-10.9 years) from the PostMortem Department of the Cairo University, Faculty of Medicine. Fixed sections were prepared and stained for c-kit. Controls for antisera specificity consisted of tissue incubated with normal rabbit serum substituted for the primary antiserum. Dendritic, c-kit-positive, ICC-like cells were detected in the tubal musculature of the studied specimens. They were distinguishable from the c-kit-positive nonbranching mast cells and from the c-kit-negative smooth muscle cells (SMC). Immunoreactivity was absent in the negative controls. We have for the first time identified cells in the FT with morphologic and immunologic phenotypes similar to the ICCs of the gut. These cells may be responsible for initiating the slow waves (SWs) recorded from the SMC of the FT. This is a preliminary study, and further studies are needed to investigate the functional role of these cells.
We report a 74-year-old woman with malignant mixed müllerian tumor and three women, aged 47, 58, and 76 years, with carcinosarcomas, all primary in the fallopian tube. The tumors grew predominantly intraluminally and were associated with hydrosalpinx. All four patients underwent salpingectomy. Two of them received radiation therapy; one died within 9 months because of the tumor and the second is well 2 years after diagnosis. Of the two women without additional therapy, one is alive with tumor 53 months postoperatively and the other is well 1 year after surgery. Available data suggest that these neoplasms are relatively radioresistant and that their prognosis correlates best with local invasiveness.
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A prospective study of 47 healthy women undergoing tubal sterilisation for contraception was undertaken to find out the rate of isolation of Chlamydia trachomatis from fallopian tubes of these individuals. Chlamydia trachomatis was isolated from the tubes in 7 (14.9%) out of 47 of them. The possible role of this pathogen in the aetiology of salpingitis in our population is discussed.
OBJECTIVE: The purpose of this study was to determine the feasibility of laparoscopically staging patients with incompletely staged cancers of the uterus, ovary, fallopian tube, and primary peritoneum, and to evaluate related effects. STUDY DESIGN: Patients without evidence of metastatic disease had laparoscopic bilateral para-aortic and pelvic lymph node dissection. Other procedures were individualized based on extent of the primary surgery; laparotomy was undertaken for identified resectable disease. RESULTS: Ninety-five eligible patients were entered on 2 Gynecologic Oncology Group (GOG) protocols. Eleven were excluded. Fifty-eight patients (69%) underwent complete endoscopic staging with photographic documentation. Nine others (10%) were incompletely staged. Seventeen patients (20%) had laparotomy. In patients undergoing laparoscopy, 6% had bowel complications; 11% were found to have more advanced disease. Hospital stay was significantly shorter with laparoscopy alone (3 vs 6 days, P = .04). CONCLUSION: Interval laparoscopic staging of gynecologic malignancies can be successfully undertaken in selected patients, but laparotomy for adhesions or metastatic disease and risk of visceral injury may be anticipated.
A case of bilateral tubal carcinoma occurring 22 years after tubal sterilization is presented. We believe that this is the first case report of bilateral tubal carcinoma that has arisen in ligated fallopian tubes. The possibility that tubal occlusion is one of the causative factors of tubal carcinoma is discussed.
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Reports of tubal microsurgical transposition techniques to restore fertility are quite rare. In this article, an interesting microsurgical procedure, in a woman with congenital uterine and tubal abnormality is presented. Under certain circumstances, microsurgical transposition of the human fallopian tube has the potential of being a useful therapeutic alternative.
PURPOSE: To evaluate the safety and efficacy of CT-2103, a novel conjugate of paclitaxel and poly-L-glutamic acid, in heavily pretreated patients with recurrent ovarian, fallopian tube, or peritoneal cancer. PATIENTS AND METHODS: Ninety-nine patients with measurable disease received intravenous CT-2103 at 175 mg/m2 of conjugated paclitaxel over 10 minutes every 3 weeks without routine premedications. Platinum-sensitive (n = 42) and platinum-refractory or platinum-resistant patients (n = 57) were enrolled. Thirty-nine patients (39%) had received one or two prior regimens, and 60 patients (61%) had received between three and 12 regimens. RESULTS: In 99 patients, the median number of cycles was three (range, one to 14 cycles). The response rate (RR) for all patients was 10% (10 of 99 patients), with median time to disease progression (TTP) of 2 months. The RR (partial response) in platinum-sensitive and platinum-resistant patients was 14% (six of 42 patients) and 7% (four of 57 patients), respectively. In patients with only one or two prior regimens, the RR in platinum-sensitive and platinum-resistant patients was 28% (five of 18 patients) and 10% (two of 21 patients), with a median TTP of 4 and 2 months, respectively. Grade 2 (15 patients) or 3 (15 patients) neuropathy was reported in 30 patients (30%). Grade 2 hypersensitivity occurred in eight patients (8%) who were subsequently treated with premedications; one patient had grade 3 hypersensitivity and was removed. Grade 2 alopecia was absent. CONCLUSION: CT-2103 is active in patients with recurrent ovarian cancer. Neurotoxicity in these heavily pretreated patients was more frequent than predicted from phase I trials. Further study to define toxicity and efficacy in patients with less prior therapy is ongoing.
There is an ever-present possibility that the children or husband of a sterilized woman may die. In the latter case, and after remarriage, she and her new husband may want children of their own, which presents difficulties, as the low success rate of reconstructive surgery in the sterilised woman is well known. A case history is presented of the first sterilized woman to undergo Fallopian tube transplantation.