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Primary adenocarcinoma of the fallopian tube.

Nineteen women with a mean age of 62 were treated for primary adenocarcinoma of the fallopian tube from 1960 to 1980. Common presentations were bleeding or discharge, pelvic mass, and pain. Cervical cytology was positive in five of eleven cases; endometrial curettings revealed adenocarcinoma in three of nine cases. Staging was by a system analogous to the International Federation of Gynecology and Obstetrics (FIGO) classification of ovarian carcinoma: 11% stage I, 44% stage II, 28% stage III, and 17% stage IV. Bleeding and abnormal cervical cytology were associated with earlier stage lesions and better prognosis. The most common treatment was excision of the primary tumor and gross intraperitoneal metastases. Total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed in 14 cases. Thirteen patients received 40-50 Gray of 2 MeV external beam pelvic radiation. Stages I and II had five-year survival of 100% and 63%. However, 38% of stage II patients had late extrapelvic relapses, and two early stage patients suffered serious complications of radiation therapy. All stage III and IV patients died of disease, 63% within the first 3 years. Based upon these results and review of other modern series, the importance of early diagnosis and complete surgical staging is emphasized, and stage-specific adjuvant therapy recommended.

Adenocarcinoma↗

[Tubal adenocarcinoma. Apropos of 4 cases and review of the literature].

The authors describe 4 cases of tubal cancer reported in the gynaecology department of the University Hospital in Caen and review the international literature. If all authors are in agreement on the early symptoms (leukorrhea, haemorrhages, pelvic pain), the lack of diagnosis before the procedure, the lack of information regarding the staging and the grading, as well as the surgical and radiation treatment, there is, above all, controversy regarding the use of chemotherapy, since the low number of patients in the different series does not permit reaching a conclusion.

Adenocarcinoma↗

Carcinoma of the fallopian tube presenting as renal failure: case report.

We describe a patient with carcinoma of a fallopian tube initially presenting with oliguric renal failure. Urinary tract symptoms are uncommon as a result of this rare tumor, and renal failure due to bilateral ureteral obstruction by nodal metastases has not been reported previously as a complication.

Acute Kidney Injury↗

[Seven cases of primary adenocarcinoma of the fallopian tube].

Seven patients with primary adenocarcinoma of the fallopian tube were treated at Kyushu University Hospital from 1978 to 1987. They were 0.59% of all patients with gynecologic malignancies in our hospital. Their mean age was 56.0 years old. Four of 7 patients presented with abnormal genital bleeding. Pelvic mass was detected in 6 of 7 patients. One patient showed abnormal cervical cytology and 3 of 6 patients had positive endometrial cytology and/or histology. No diagnosis of tubal cancer was made preoperatively. Primary surgical treatments were performed in all patients. Four patients, who underwent dissection and/or biopsy of pelvic and paraaortic lymph nodes, had no metastasis. However, at the time of recurrence, paraaortic and/or neck lymph nodes metastases were present in 3 of 4 patients. Following surgery, combination chemotherapy with cyclophosphamide, doxorubicin and cisplatin (CAP) was administered to 6 of 7 patients. Partial responses were obtained in 2 patients with recurrent and evaluable lesions. The mean survival time of 7 patients as yet was 36.0 months after diagnosis. In conclusion, the difficulty of preoperative diagnosis of tubal cancer was reconfirmed. CAP combination chemotherapy seemed to be effective for the treatment of tubal cancer and further study with more cases is warranted.

Adenocarcinoma↗

Cystadenofibroma of fallopian tube.

We present two cases of cystadenofibroma of the fallopian tube in 2 patients of 49 and 32 years, respectively. The first tumor was a chance finding in a hysterosalpingo-oophorectomy because of multiple leiomyomas. The second tumor appeared in a pregnant woman; the tumor was considered in an echographic study as an ectopic pregnancy. This tumor was a borderline cystadenofibroma. The second case is the first report of cystadenofibroma of the fallopian tube associated with pregnancy.

Adenofibroma↗

[Endometriosis within the scope of sterility treatment].

Endometriosis is one of the most frequent diseases in connection with female sterility, 3.2 per cent endometriosis was diagnosed in all operative cases from 1964 to 1984 but in all cases of sterility there were 10.8 per cent. Essentially these were cases of severe endometriosis genitalis externa (78.6 per cent) according to the Acosta-classification. The rate of recoquition of endometriosis as a possible reason for sterility has been increased from 2.4 per cent to 9.9 per cent since the general introduction of laparoscopy into the diagnosis of hitherto unsolved cases of sterility in 1980. A combined laparoscopic-hormonal therapy pattern is presented here. A corrected pregnancy rate below 30% after endometriosis therapy indicates that there are much more possibilities for therapy of this diseases.

Danazol↗

Intraoperative complications and unexpected pathology at the time of cesarean section.

During cesarean section, operative complications include injury to the uterus, urinary tract, and bowel. A variety of types of fetal injuries have been reported, and some are associated with permanent handicap. The relative risk of intraoperative complications varies widely depending on such clinical variables as gestational age, station of the presenting part, and the experience of the operating physician. Ideally, each physician should be able to review his or her rate and type of complications so that continuous improvement in technique is fostered. Gynecologic tumors (malignant and benign) are rarely associated with pregnancy, and their incidental finding at the time of cesarean section is also rare. Management of malignant tumors depends greatly on the stage of the tumor. Conservative management of early-stage malignant ovarian tumors is permissible. More advanced malignant ovarian tumors and malignant tumors of the uterus and fallopian tube should be treated aggressively with removal of the reproductive organs.

Cesarean Section↗