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].

• Ascites

  Growth limited to one tube with extension into submucosa and/or muscularis, but not penetrating the serosal surface, no ascites. Ascites refer to a build-up of abdominal fluid that may occur as a result of cancer or other illnesses. Stage IB. [pennmedicine.org]

  In all these cases there was neither clinical nor perioperative suspicion of PFTC and the first clinical diagnosis was ovarian carcinoma which was supported by positive cytology for ascitic fluid and raised serum level of CA125. [ncbi.nlm.nih.gov]

  There is no penetration of the serosal surface and there is also no ascites. Stage 1C It involves either Stage IA or Stage IB which extends on the serosal surface or with ascites. The fluid from the ascites contains malignant cells. [cancerwall.com]

• Severe Pain

  MATERIALS AND METHODS: A 19-year-old woman presented with a history of pelvic pain and severe dysmenorrhea. Ultrasound examination initially suggested bilateral ovarian dermoids. [cancerindex.org]

• 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]

• 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 Mass

  We described a patient who had back pain, an epigastric abdominal mass, a palpable right kidney and a palpable scalene node. [ncbi.nlm.nih.gov]

  […] vaginal discharge (20%) and a palpable pelvic/abdominal mass (61%). [9] The patients presents with the typical clinical symptoms termed as "hydrops tubae profluens" that is, they will have pelvic pain, lower abdominal mass, and serosanguinous vaginal [ccij-online.org]

  Abdominal pain, vaginal bleeding, hydrohematorrhea, impaired general condition and palpation of a pelvic mass are the most common symptoms during the primary cancer of the fallopian tube [ 11 ]. [panafrican-med-journal.com]

  In a retrospective study of 151 patients, it was noted that the patients usually present with abnormal vaginal bleeding (47.5%), lower abdominal pain (39%), abnormal watery vaginal discharge (20%) and a palpable pelvic/abdominal mass (61%) ( 10 ). [e-crt.org]

• Osteoporosis

  Because the ovaries are the source of the hormone estrogen, which helps controls the menstrual cycle, keeping them in place helps prevent premature menopause, which is associated with heart disease, osteoporosis, neurological and psychiatric diseases, [statnews.com]

  Bilateral salpingo-oophorectomy that causes surgical menopause reduces the risk of ovarian cancer but may increase the risk of cardiovascular disease, osteoporosis, and cognitive impairment ( 15 ). [acog.org]

  […] an alternative to surveillance alone in high-risk BRCA -positive patients reluctant to undergo bilateral salpingo-oophorectomy (BSO) for risk reduction of pelvic serous carcinomas, due to concerns of prolonged menopause and other complications (like osteoporosis [dovepress.com]

• Confusion

  In fact, the tubal carcinoma is often confused with his ovarian counterpart which have several similarities. The prognosis is relatively dark, but still better than ovarian carcinoma. [omicsonline.org]

  Among ovarian surface epithelial tumors, the origin of intestinal-type mucinous ovarian and Brenner tumors is even more confusing than that of serous tumors as they lack a Mullerian phenotype. [wjgnet.com]

• Vaginal Bleeding

  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]

• Vaginal Discharge

  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]

  Patients generally suffer from the three symptoms: vaginal bleeding, pelvic pain, and vaginal discharge; however, this is usually not sufficient for confirming the diagnosis preoperatively in most circumstances. [ncbi.nlm.nih.gov]

• Adnexal Mass

  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]

  Most patients present with an adnexal mass or report vague abdominal or pelvic symptoms (eg, abdominal discomfort, bloating, pain). [msdmanuals.com]

  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]

• Salpingitis

  There are only a few reports on primary carcinoma of the fallopian tube coexisting with tuberculous salpingitis. [ncbi.nlm.nih.gov]

  Pseudo-xanthomatous salpingitis (referred to as ‘‘pigmentosis tubae’’) is associated with endometriosis, yet it also might result from salpingitis with associated hemorrhage[ 1, 16, 17 ]. [wjgnet.com]

  The diagnosis of acute salpingitis begins with a thorough patient history. [mdedge.com]

• 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]

  Bilateral lower quadrant tenderness with rebound tenderness was noticed on the physical examination. She had findings of acute panperitonitis. On the pelvic examination, she had cervical motion and adnexal tenderness. [e-crt.org]

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].

• Ovarian Mass

  A vague mass was palpable in the lower abdomen. Transvaginal ultrasonography revealed bilateral tubo-ovarian masses. Patient underwent abdominal hysterectomy with bilateral salpingo-oophorectomy. [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 without STIC should be classified as ovarian primaries. [nature.com]

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

Diagnosis, staging, and primary treatment are surgical. High-grade serous epithelial ovarian carcinoma, fallopian tube, and peritoneal carcinomas share clinical behavior and treatment. Primary fallopian tube cancer is rare. [msdmanuals.com]

In most cases, a brief delay does not make treatment less effective. [roswellpark.org]

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]

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]

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]

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]

Presumably, dynamic emptying and filling of the Fallopian tube blocked by the tumor is the related pathophysiological mechanism of hydrops tubae profluens. [symptoma.com]

[…] 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]

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