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Fallopian Tube Carcinoma

Fallopian Tube Cancer Carcinoma

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.


Presentation

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].

Weakness
  • A 63-year-old woman presented with 3 weeks of progressive left-sided weakness. CT scan of the brain revealed a solitary lesion in the right parietal lobe. The patient underwent a complete resection, followed by whole-brain radiation therapy.[ncbi.nlm.nih.gov]
  • Such staining is usually focal and weak and somewhat variable from area to area (referred to as ‘wild-type’ p53 staining), although on occasions many of the nuclei are positive, albeit with variable intensity.[nature.com]
Anemia
  • Toxicity was mainly hematological with grade 3-4 toxicity as follows: leukopenia--two (9.5%) patients, neutropenia--four (19%), thrombocytopenia--three (14.3%) and anemia--one (4.7%).[ncbi.nlm.nih.gov]
Painter
  • There was a nonsignificant increased risk for PFTC among welders, printers, painters and chemical process workers.[ncbi.nlm.nih.gov]
Dyspnea
  • A 57-year-old healthy woman was admitted with dyspnea. Evaluation demonstrated a right pleural effusion, fluid of which was malignant.[ncbi.nlm.nih.gov]
  • However, there were more grade 3 and 4 side effects, including dyspnea, fatigue, and dehydration. There were also three intestinal perforations with aflibercept.[dovepress.com]
Pneumonia
  • Serum samples were analysed for IgG antibodies to different C. trachomatis serotype pools and to C. pneumoniae.[ncbi.nlm.nih.gov]
Pelvic Mass
  • Actually all these three cases presented as tubo-ovarian abscess because of the existence of tender pelvic mass.[ncbi.nlm.nih.gov]
Abdominal Pain
  • We report the case of a 56-year-old woman who presented with a 2 1/2-year history of intermittent vaginal bleeding and lower abdominal pain.[ncbi.nlm.nih.gov]
Peritoneal Disease
  • Although this is the first reported case of colon metastasis of PFTC, the possibility of such an unusual site of metastasis should be kept in mind, as PFTC may recur as isolated bowel lesions even in the absence of peritoneal disease.[ncbi.nlm.nih.gov]
  • Kyriazi S, Collins DJ, Morgan VA, Giles SL, deSouza NM (2010) Diffusion-weighted imaging of peritoneal disease for noninvasive staging of advanced ovarian cancer. Radiographics 30:1269–1285 PubMed CrossRef Google Scholar 39.[springerlink.com]
  • disease) have a relatively favourable outcome although it should be noted that the data are based mainly on cases of serous carcinoma. 71 , 72 Positive extra-abdominal lymph nodes, including inguinal metastases, represent stage IVB disease.[nature.com]
Diplopia
  • Abstract This is the case report of a 61-year-old woman who presented with progressive diplopia and ataxia.[ncbi.nlm.nih.gov]
Dermatitis
  • A woman presented with severe exfoliative dermatitis and a pelvic mass subsequently found to be fallopian tube carcinoma. After resection of the tumor and four courses of cisplatin, doxorubicin, and cyclophosphamide, the skin condition cleared.[ncbi.nlm.nih.gov]
Thigh Pain
  • After surgery, the patient had progressive right thigh pain with activity. Radiographs of the femur showed a lytic lesion in the right proximal femur diaphysis with erosion of the medial cortex.[ncbi.nlm.nih.gov]
Myalgia
  • A 41-year-old woman presented with facial erythema and myalgia of the extremities. The patient was diagnosed with DM associated with a fallopian-tube carcinoma.[ncbi.nlm.nih.gov]
Myopathy
  • Dermatomyositis (DM) is an idiopathic inflammatory myopathy associated with characteristic cutaneous and extracutaneous manifestations, including malignancy.[ncbi.nlm.nih.gov]
Myelopathy
  • Diagnosis of radiation myelopathy in women with gynecologic malignancies may increase with the concomitant use of chemotherapy and radiation therapy.[ncbi.nlm.nih.gov]
  • Higgins RV, Myers VT, Hall JB: Radiation myelopathy after chemotherapy and radiation therapy for fallopian tube carcinoma. Gynecol Oncol 1997;64:285–287.[karger.com]
Adnexal Mass
  • 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.[symptoma.com]
  • During laparotomy, bilateral adnexal masses were identified, presumed to be of ovarian origin, and total abdominal hysterectomy, bilateral salpingo-oophorectomy, infracolic omentectomy, and retroperitoneal lymph nodes sampling were performed.[ncbi.nlm.nih.gov]
Adnexal Tenderness
  • Mucopurulent (green or yellow) discharge on speculum examination and acute cervical motion tenderness, uterine or adnexal tenderness are indicative for PID and TOA.[cancertherapyadvisor.com]
  • On the pelvic examination, she had cervical motion and adnexal tenderness.[e-crt.org]
Female Sterility
  • We studied the possible relationship among parity, female sterilization, hysterectomy and the risk of primary fallopian tube carcinoma (PFTC) in a case-control study in Finland in cases occurring between 1975 and 2004.[ncbi.nlm.nih.gov]

Workup

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].

Right Pleural Effusion
  • Evaluation demonstrated a right pleural effusion, fluid of which was malignant. The immunohistochemical profile, including negative calretinin, favored metastatic adenocarcinoma over mesothelioma but could not identify the primary tumour site.[ncbi.nlm.nih.gov]
Ovarian Mass
  • Transvaginal ultrasonography revealed bilateral tubo-ovarian masses. Patient underwent abdominal hysterectomy with bilateral salpingo-oophorectomy. On gross examination, uterus, cervix and ovaries were normal.[casereports.in]
  • Left-sided tubo-ovarian mass was present, cut section of which showed yellowish solid area in tubal wall and encroaching on ovarian surface.[jmidlifehealth.org]
  • […] associated with the finding of STIC (11%) as compared to those patients without a dominant ovarian mass (45%).[cancerjournal.net]
  • Cases with a dominant ovarian mass(es) and identifiable fallopian tubes with STIC should be classified as tubal primaries.[nature.com]

Treatment

  • This report demonstrates the significance of anti-angiogenesis therapy in the treatment of these tumors.[ncbi.nlm.nih.gov]

Prognosis

  • Multifactor analysis showed that a residual tumor diameter 1 cm (P 0.019) and omentum metastasis (P 0.015) were associated with prognosis, and were, therefore, the independent risk factors of prognosis.[ncbi.nlm.nih.gov]

Etiology

  • The etiology, incidence, natural history, treatment and prognosis of fallopian tube carcinoma and retroperitoneal fibrosis are discussed.[ncbi.nlm.nih.gov]
  • Conclusion Primary tubal cancer is rare, of unknown etiology and sometimes mistaken for uterine or ovarian pathology. The clinical signs are rarely present in full. The diagnosis is rarely made preoperatively or on histology.[panafrican-med-journal.com]

Epidemiology

  • In this chapter, we clarify the possible epidemiological factors behind this disease.[ncbi.nlm.nih.gov]
  • The authors report a review of the literature regarding the epidemiology, diagnosis, treatment and prognosis of this cancer. Introduction Primary cancer of the fallopian tube is very rare [ 1-4 ].[panafrican-med-journal.com]
Sex distribution
Age distribution

Pathophysiology

  • Presumably, dynamic emptying and filling of the Fallopian tube blocked by the tumor is the related pathophysiological mechanism of hydrops tubae profluens.[symptoma.com]
  • Pathophysiology of Fallopian Tube Cancer 673 views Fallopian tube cance r develops in the tubes that connect a woman's ovaries and uterus . It is very rare and accounts for only 1-2% of all gynecological cancers.[checkorphan.org]

Prevention

  • […] in order to prevent what they were still calling ovarian cancer.[statnews.com]
  • “We have an opportunity to … embrace a new surgical paradigm for ovarian cancer prevention.”[cmaj.ca]
  • Fallopian Origin and Prevention of Ovarian Cancer A proposed model for ovarian carcinogenesis arising in the fallopian tube has emerged over the last decade [9, 10].[journalofethics.ama-assn.org]
  • Causes, Risk Factors, and Prevention Learn about the causes and risk factors associated with ovarian cancer. Read here about how you might help lower your risk.[cancer.org]
  • Prophylactic salpingectomy may offer clinicians the opportunity to prevent ovarian cancer in their patients.[acog.org]

References

Article

  1. Veloso Gomes F, Dias JL, Lucas R, Cunha TM. Primary fallopian tube carcinoma: review of MR imaging findings. Insights Imaging. 2015;6(4):431-439.
  2. Rezvani M, Shaaban AM. Fallopian tube disease in the nonpregnant patient. Radiographics. 2011;31(2):527-548.
  3. Pectasides D, Pectasides E, Economopoulos T. Fallopian tube carcinoma: a review. Oncologist. 2006;11(8):902-912.
  4. Jeung IC, Lee YS, Lee HN, Park EK. Primary Carcinoma of the Fallopian Tube: Report of Two Cases with Literature Review. Cancer Res Treat. 2009;41(2):113-116.
  5. Kalampokas E, Kalampokas T, Tourountous I. Primary fallopian tube carcinoma. Eur J Obstet Gynecol Reprod Biol. 2013;169(2):155-161.
  6. Chaudhry S, Hussain R, Zuberi MM, Zaidi Z. Rare primary fallopian tube carcinoma; a gynaecologist's dilemma. J Pak Med Assoc. 2016;66(1):107-110.
  7. Lau HY, Chen YJ, Yen MS, Chen RF, Yeh SO, Twu NF. Primary fallopian tube carcinoma: a clinicopathologic analysis and literature review. J Chin Med Assoc. 2013;76(10):583-587.

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Last updated: 2019-06-28 10:23