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PubMed1996

Placental site nodule occurring in a fallopian tube.

The placental site nodule (PSN), a recently described benign lesion of intermediate trophoblast, is usually an incidental finding in younger women. It is a well-circumscribed, round to oval lesion that is extensively hyalinized and immunohistochemically stains for cytokeratin, placental alkaline phosphatase (PLAP), human placental lactogen (HPL) and, focally, for human chorionic gonadotropin (HCG) and epithelial membrane antigen (EMA). Thus far, the cases reported have been found in endometrial curettage or hysterectomy specimens. The pathogenesis of PSN is yet to be ascertained; however, there is wide acceptance of the fact that it represents a remnant of the placental implantation site. If this is indeed the case, it should not be surprising to find PSN occurring at sites of ectopic gestation. We describe herewith a case in which PSN was found in a fallopian tube segment resected in a postpartum tubal ligation.

Adult↗
PubMed1980

Unconjugated steroids in the fallopian tube and peripheral blood during the normal menstrual cycle.

Daily plasma samples were obtained from 22 high-parity normal women beginning on day 9 of the menstrual cycle. At varying times in the cycle, salpingectomy was performed and the excised tube was divided into isthmic, ampullary, and fimbrial segments. Simultaneous determinations of 17 beta-estradiol (E2), estrone (E1), and progesterone (P) in plasma and tubal tissue were carried out by specific radioimmunoassay. The highest ratio for E2 tissue to E2 plasma was seen at the time of the E2 peak. The E2 concentrations in the three anatomical segments of the fallopian tube during the late proliferative phase were significantly (P less than 0.05) higher than those during the early proliferative and late postovulatory periods. A significant (P less than 0.05) increase in P concentration was seen in both plasma and oviductal tissue after ovulation. The tubal tissue to plasma ratio had a tendency to decrease during the secretory phase, indicating a limited uptake of P during the secretory phase. The plasma levels of esterone were almost constant during the normal menstrual cycle. The highest concentration of E1 was seen in the fimbriae (254 +/- 71 pg/gm and ampulla (326 +/- 75 pg/gm during the early secretory phase of the cycle. The possible role of E1 during this crucial time of oviductal physiology is considered.

Adult↗
PubMed2004

Phase 2 trial of carboplatin, paclitaxel, and irinotecan in ovarian, fallopian tube, and primary peritoneal cancers.

OBJECTIVE: Our goal in this nonrandomized phase 2 trial was to evaluate the toxicity and obtain preliminary data on the potential efficacy of a novel three-drug combination regimen (carboplatin-paclitaxel-irinotecan) when employed as initial therapy of advanced ovarian cancer or as second-line treatment in the setting of a prolonged (>or=12 months) treatment-free interval. METHODS: Patients with a histologically confirmed diagnosis of advanced ovarian cancer, primary adenocarcinoma of the peritoneum, or fallopian tube cancer were enrolled in the study. Patients received carboplatin (AUC 5), paclitaxel (150 mg/m(2) over 3 h), and irinotecan (100 mg/m(2) over 90 min). The three-drug combination was initially administered on an every 21-day schedule, but due to toxicity was subsequently changed to a 28-day program. RESULTS: A total of 30 patients were enrolled into this phase 2 trial. Twenty-three patients were chemotherapy naive, while 7 had received prior chemotherapy. Seventeen patients completed all six cycles of treatment. Eight patients (27%) were removed from the study after a median of three cycles due to toxicities. Seventeen patients (57%) experienced grade 4 neutropenia, with three individuals requiring hospitalization for neutropenic fever and dehydration. Grades 3 and 4 thrombocytopenia were experienced by three patients each. The principal nonhematologic toxicities were diarrhea (grade 3: three patients) and fatigue. The overall objective clinical response rate was 83%. CONCLUSIONS: The combination of carboplatin-paclitaxel-irinotecan can be administered to women with advanced ovarian cancer with significant, but overall acceptable toxicity. Modification of the regimen from a 3-week to a 4-week schedule permits a greater percentage of patients to complete the program without experiencing excessive toxicity. The overall objective response rate observed in this trial is comparable to other combination regimens employed in this setting. Defining a place for this three-drug program in the standard management of ovarian cancer will require the conduct of an appropriately designed randomized trial.

Adult↗
PubMed2000

Phase 2 trial of liposomal doxorubicin (40 mg/m(2)) in platinum/paclitaxel-refractory ovarian and fallopian tube cancers and primary carcinoma of the peritoneum.

BACKGROUND: Several studies have demonstrated liposomal doxorubicin (Doxil) to be an active antineoplastic agent in platinum-resistant ovarian cancer, with dose limiting toxicity of the standard dosing regimen (50 mg/m(2) q 4 weeks) being severe erythrodysesthesia ("hand-foot syndrome") and stomatitis. We wished to develop a more tolerable liposomal doxorubicin treatment regimen and document its level of activity in a well-defined patient population with platinum/paclitaxel-refractory disease. METHODS AND MATERIALS: Patients with ovarian or fallopian tube cancers or primary peritoneal carcinoma with platinum/paclitaxel-refractory disease (stable or progressive disease following treatment with these agents or previous objective response <3 months in duration) were treated with liposomal doxorubicin at a dose of 40 mg/m(2) q 4 weeks. RESULTS: A total of 49 patients (median age: 60; range 41-81) entered this phase 2 trial. The median number of prior regimens was 2 (range: 1-6). Six (12%) and 4 (8%) patients experienced grade 2 hand-foot syndrome and stomatitis, respectively (no episodes of grade 3). One patient developed grade 3 diarrhea requiring hospitalization for hydration. Six (12%) individuals required dose reductions. The median number of courses of liposomal doxorubicin administered on this protocol was 2 (range: 1-12). Four of 44 patients (9%) evaluable for response exhibited objective and subjective evidence of an antineoplastic effect of therapy. CONCLUSION: This modified liposomal doxorubicin regimen results in less toxicity (stomatitis, hand-foot syndrome) than the standard FDA-approved dose schedule. Definite, although limited, antineoplastic activity is observed in patients with well-defined platinum- and paclitaxel-refractory ovarian cancer.

Adult↗
PubMed1982

[Endoscopic diagnosis preceding reconstructive surgery of the fallopian tube].

Between October 1978 and December 1980 165 diagnostic laparoscopies were carried out because of the suspected diagnosis of primary tubal infertility. In this preselected series 27.9% of the cases had normal findings. It was remarkable that the previous diagnosis was not confirmed in 21 cases which had a prior infertility work-up. In 17 of these cases tubal occlusion was diagnosed by laparoscopy or hysterosalpingography but was not confirmed by the repeat laparoscopy. In addition 1 case of tubal tuberculosis and 1 case of tubal anomaly were detected which were missed with the prior work-up. Because of the findings in this series the repeat diagnostic laparoscopy prior to micro-surgical reconstruction of the fallopian tubes is necessary and the referring clinics should show comprehension for the repeat laparoscopy prior to micro-surgery. In the sequence of diagnostic test, laparoscopy it selected prior to hysterosalpingography.

Adult↗
PubMed2006

Phenotypic variability of a 4q34-->qter inherited deletion: MRKH syndrome in the daughter, cardiac defect and Fallopian tube cancer in the mother.

Terminal deletions of the long arm of chromosome 4 are associated with a recognizable phenotype consisting of dysmorphic facial features, cleft palate, upper and lower limb malformations, cardiac defects and growth and mental retardation. Here we report on two female patients, a mother and her daughter, carrying the same 4q34-->qter deletion but presenting with a different phenotype. The mother's presentation is consistent with previous findings in patients with terminal deletions of the long arm of chromosome 4. However, she presented at the age of 54years with bilateral serous carcinoma of the Fallopian tubes, a rare gynaecologic cancer that might be attributed to the haploinsufficiency of the tumor suppressor gene FAT. The daughter presented isolated congenital aplasia of the uterus and vagina, the prime feature of the MRKH syndrome. This has not been described before in association with a 46,XX,del(4)(q34qter).

Adolescent↗
PubMed1997

Bilateral absence of the ovaries and distal fallopian tubes. A case report.

BACKGROUND: Bilateral tuboovarian absence is extremely rare and is associated with infantile sexual development, primary amenorrhea and primary infertility. CASE: A 23-year-old woman presented for evaluation of primary amenorrhea. Her examination revealed hypoplastic breasts, genitalia and uterus; ovaries could not be identified. Marked estrogen deficiency was confirmed by endocrinologic testing. The karyotype was normal female. The patient was started on combined hormone replacement therapy and subsequently developed normal menses; physical maturation progressed normally. At the age of 29 she underwent diagnostic laparoscopy for evaluation of her fertility potential, at which time the absence of both ovaries and distal fallopian tubes was confirmed. CONCLUSION: Bilateral tuboovarian absence is an extremely rare cause of primary amenorrhea and is associated with infantile sexual development and primary infertility. Its etiology includes tuboovarian torsion and congenital malformation. In this case, congenital malformation appears to have been the more likely cause.

Adult↗
PubMed1976

The alleviation of uterocornual spasm of the Fallopian tubes during hysterosalpingography by intravenous administration of orciprenaline.

A simple, safe and reliable method of differentiating between organic obstruction spasm at the uterocornual junction of the oviduct during routine hysterosalpingography is described. Seventeen patients were studied. In all patients uterocornual obstruction was found during hysterosalpingography, which was performed without general anaesthesia. In 8 patients the apparent obstruction was alleviated within 30 seconds of the intravenous administration of 0.25 mg orciprenaline. Surgical and endoscopic findings confirmed the presence of the obstruction in all the other 9 patients. These findings are discussed on the basis of the neuro-anatomy of the Fallopian tube. It is suggested that this form of treatment, in many cases, eliminates the need to perform the procedure under general anaesthesia, which is the only other method of consistently alleviating such a 'spasm'. The use of orciprenaline may facilitate a rapid turnover of patients in units where hysterosalpingography is performed as a screening investigation for infertility. Furthermore, it is suggested that the oral administration of beta-adrenergic agents during the peri-ovulatory period to patients in whom 'tubal spasm' has been diagnosed might offer a rational approach to treatment.

Diagnosis, Differential↗
PubMed1994

Carcinoma of the fallopian tube. A clinical and histopathologic review. The Radiumhemmet series.

A histopathologic and clinical review of the Radiumhemmet series of primary fallopian tube carcinoma (PFTC) treated from 1923 to 1991 revealed that 128 cases fulfilled the diagnostic criteria for PFTC. These cases were staged according to the new FIGO staging rules for PFTC. Survival was studied with respect to prognostic factors such as age, stage, histologic subgroups, degree of differentiation and mode of treatment. The mean age at diagnosis was 56 years. Seventy-four per cent were found to be in stage Ia-IIa and 26 % in stage III-IV. Forty-five per cent were nulliparous and 22 % had evidence of previous pelvic inflammatory disease. Treatment modalities changed during the studied period. Thirty-three per cent of patients underwent surgery with total abdominal hysterectomy and bilateral salpingo-oophorectomy while 67 % were incompletely operated. A trend towards improvement in results was noticed-however, it was not statistically significant. Among the 14 prognostic variables tested in the multivariate analysis the first in rank were stage (P = 0.001) and degree of differentiation of the tumors (P = 0.070). Patients receiving chemotherapy had superior survival rates compared with those without chemotherapy (P = 0.0006) and patients with cisplatinum-containing chemotherapy did better than those without cisplatin.

Journal Article↗
PubMed1996

[Laparoscopic diagnosis of tubal infertility and fallopian tube lesions].

OBJECTIVE: To analyse the diagnostic value of laparoscopy in patients with tubal infertility. METHODS: The morphological appearance of fallopian tubes and surrounding tissues of 1120 cases with proven tubal infertility were observed under laparoscopy. Hydrotubation was performed at the same time in each case. RESULTS: Tubal infertility diagnosed by laparoscopy accounted for 32.8% of infertile patients. Among them, pelvic tuberculosis occupied 63.6%, while nonspecific inflammatory disease (NSID) 36.4%. 44.8% of the tuberculosis and 62.2% of NSID group had negative findings during pelvic examination. Four types of tuberculosis lesions were demonstrated: miliary ascites (9.4%), adherent mass (35.8%), adhesion and calcification (43.1%), nodular sclerosis (11.7%). In the NSID group, simple tubal obstruction accounted for 29.9%, the remaining were mild adhesion or hydrosalphinx. Complete tubal occlusion occupied 81.2% in tuberculosis group and 70.7% in NSID cases. In the tuberculosis group the positive rate of pelvic lesion biopsy and endometrial biopsy was only 59.1% and 20.5% respectively. CONCLUSION: Laparoscopy examination is a valuable procedure for the etiological diagnosis of tubal infertility.

Adult↗
PubMed1996

Anatomic distortion of clinically normal appearing fallopian tube: to what extent does it contribute to infertility?

We analyzed whether patent but anatomically deranged tubes were more commonly encountered in infertile women than in fertile women. The fertile group consisted of 100 women who were apparently normal with respect to fertility and the infertile group consisted of 100 infertile women with no certain etiology identified. The individual tubal structure was recorded at laparoscopy and the results of the two groups were then compared. Tubal pathology was found to be significantly higher in the infertile group; however, this marked difference arose from the contribution of a significantly higher frequency of peritubal pelvic adhesions because no difference was found between the two groups regarding anatomic variations of the fallopian tube. We conclude that tubal derangement which could only be identified with laparoscopy significantly contributes to infertility.

Adult↗