[Case of primary fallopian tube neoplasms].
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The paper is the summary of a workshop and contains guidelines for prophylaxis, early detection, treatment and follow-up of malignant tumours of the fallopian tube recommended by the Central Institute of Cancer Research as well as the Medical Associations of the German Democratic Republic.
The distribution of cancer antigen 125 (CA 125) has been investigated in normal tissues and carcinomas of the Müllerian duct by immunohistochemical methods using the monoclonal antibody OC 125. Detection of CA 125 was most intense in cryostat sections and decreased in formalin fixed and paraffin embedded tissues according to the duration of fixation. Enzymatic digestion with neuraminidase or alkaline hydrolysis abolished specific staining suggesting the antigen is a sialylsaccharide bound to protein by alkali-labile linkage. Immunohistochemical staining demonstrated the presence of CA 125 in all normal glandular epithelia of the endocervix, endometrium and fallopian tube in different distribution patterns. In normal endometrium the cellular distribution pattern was related to the menstrual cycle. In endocervical, endometrial and tubal adenocarcinomas CA 125 was found in 73% of cases. In glandular structures the antigen was concentrated at the luminal surface of the tumour cells, in solid tumour areas it was spread throughout the cytoplasm or concentrated in large cytoplasmic vacuoles. The expression of CA 125 was considerably lower in solid tumour areas. These data show that CA 125 is not a true "tumour marker", but a product of female genital mucosae and of their cancerous derivates provided their synthesizing ability is not lost in the course of pathologic differentiation.
The study deals with the occurrence of cancer antigen 125 (CA 125) in the normal and neoplastic uterine cervix, endometrium and fallopian tube and its applicability as a tumour marker. CA 125 concentrations were measured in 52 secretion specimens, in cytosol fractions of 97 tissue biopsies and in serum from 47 women with nonmalignant disorders and from 334 patients with carcinomas. High quantities of CA 125 (780-454860 U/ml) were detected in cervical mucus, intra-uterine and tubal fluid, exceeding those in the corresponding serum samples by factors of up to 2000. CA 125 concentrations were 9-53 fold higher in cytosol fractions of normal and neoplastic glandular epithelia of the endocervix and endometrium than in those of cervical squamous epithelia and the cervical wall. Despite similarly high antigen concentrations in normal glandular epithelia and adenocarcinomas serum levels elevated to above 65 U/ml were only found in patients with malignant tumours. The positivity rates in serum increased with tumour extent and were 0-43% for primary and 63-79% for recurrent cervical, endometrial and tubal adenocarcinomas. During long-term follow-up, CA 125 serum concentrations were concordant with the clinical course in 10 out of 11 patients with progressive carcinomas. According to these results, the release of CA 125 into the peripheral blood is apparently dependent on the infiltrative growth and the mass of the tumour rather than on the local tissue concentrations. The clinical use of CA 125 is limited to the detection of advanced adenocarcinomas of the Müllerian duct.
Clinical and ultrasonographic examination are the usual methods of diagnosis for carcinomas of the fallopian tubes and ovarian carcinomas. It is only in rare cases that the diagnosis is based on the cytology of the cervical smear. The use of cytology--more exactly, the cytological examination of secretion in Douglas' space in cases of vaginal hysterectomies--for the detection of ovarian and tubal carcinomas that cannot be diagnosed by clinical and paraclinical procedures, is a rather unusual and rarely described method. However, it is quite justified, as demonstrated by the detection of two carcinomas of the fallopian tubes within a short time.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
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Three cases of primary adenocarcinoma of the Fallopian tube have been treated at the Gynecology Department of Hospital A. C. Camargo, Fundación A. Prudente, São Paulo, between 1972-1987. The diagnosis was only possible at surgery. The poor prognosis was due to the advanced stage of the disease. In view of its rarity further studies are necessary for a better diagnostic and therapeutic approach.
This is a case of malignant mixed Müllerian tumor arising primarily from the fallopian tube. The tumor was distant metastasis to the omentum and the serosa of the sigmoid colon. Literatures published in the last two decades are reviewed and discussed.
A 17-year-old female with severe pain of the midabdomen was found to have a retroperitoneal cystic tumor, an ectopic ovary and a fallopian tube without fimbriated end. An attempt is made to determine whether these early embryonic malformations could be traced to a common origin. This is possible provided that the tumor is regarded as a mesonephroma. A histological study of the normal development of the Mullerian duct was performed utilizing human embryonic series. Previous development theories and more recent investigations are discussed. Malformations of the tube described in the literature and possible etiologies are summarized.
A case of tubal carcinoma is presented, which was initially misdiagnosed as an endometrial carcinoma. This was due to a superficial metastasis yielding material during the curettage which simulated an anaplastic adenocarcinoma. The difficulty of correctly diagnosing tubal carcinoma preoperatively has been discussed.
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A case of early bilateral serous papillary adenocarcinoma of the ovaries in an asymptomatic 58-year-old woman was diagnosed by the discovery of psammoma bodies in routine cervicovaginal and endometrial smears. Multiple small foci of carcinoma in-situ involving both fallopian tubes were also present. The significance of psammoma bodies in the cervicovaginal smear is discussed and the literature on the subject briefly reviewed.