Fallopian tube carcinoma is a very rare tumor of the female reproductive tract. Typical manifestations are the presence of an adnexal mass, abdominal or pelvic pain, and vaginal discharge that relieves pain, although they are not always present. The diagnosis is made postoperatively or through the use of imaging studies and histopathological examination of the tumor.
Fallopian tube carcinoma is rarely encountered in clinical practice (incidence rates estimated at 3.6 in 1,000,000 women every year), comprising less than 2% of all malignancies of the female genital tract [1]. The tumor primarily affects women in their 5th, 6th, and 7th decades of life [1] [2]. Typical clinical presentation of fallopian tube carcinoma, known as the Latzko triad, encompasses three elements, namely a mass in the adnexal region, colicky abdominal or pelvic pain, and its relief after the appearance of a serosanguineous vaginal discharge [2] [3] [4] [5]. The term hydrops tubae profluens is used to describe the intermittent vaginal discharge spontaneously or after pressure, resulting in the decrease of the adnexal mass, and is considered to be a pathognomonic feature of fallopian tube carcinoma [3] [5]. Presumably, dynamic emptying and filling of the Fallopian tube blocked by the tumor is the related pathophysiological mechanism of hydrops tubae profluens [2] [3]. Only 15% of women present with the Latzko triad while hydrops tubae profluens is seen in only 5% of cases [2] [4]. Thus, the nonspecific clinical presentation and the rare occurrence of typical signs and symptoms might be the reasons why clinical suspicion is not raised early on, leading to a delayed diagnosis and poorer treatment outcomes [4] [5].
To make the diagnosis of Fallopian tube carcinoma, it is necessary to conduct a thorough workup. A detailed patient history and a meticulous physical examination are the first steps in raising suspicion toward this malignancy, but because typical signs and symptoms are not always present, imaging studies are the cornerstone in making the initial diagnosis [2] [3] [4]. Abdominal (but also transvaginal) ultrasonography is a very useful initial method in detecting a tumor in the area where the Fallopian tubes are located, but many reports have revealed that the mass may be often misidentified as ovarian carcinoma [2] [4] [5] [6] [7]. However, more advanced methods, such as magnetic resonance imaging (MRI), are used to confirm the diagnosis [2] [3]. A small tubular or sausage-shaped mass that exerts low signal intensity on T1-weighted imaging and high signal intensity on T2-weighted imaging are main findings on MRI [2] [7]. Computed tomography (CT), on the other hand, is beneficial for determining the stage of the tumor. Histopathological examination is often performed postoperatively [2]. The cancer antigen 125 (CA-125) is a protein tumor marker that is frequently expressed by carcinoma of the Fallopian tube, and its assessment should be done whenever clinical and radiographic findings point to an adnexal mass [4] [6] [7].