Background: Historically, primary fallopian tube carcinoma
has been reported to constitute only about 0.3% of all female genital tract
malignancies. However, literature suggests that its actual incidence may be
higher, as many cases are often classified as ovarian cancer. Preoperative
diagnosis is difficult and challenging due to the absence of specific symptoms.
Clinically, fallopian tube carcinoma resembles epithelial ovarian cancer, and
histologically, it is also similar; hence, its evaluation and treatment are
essentially the same.
Objective: As primary fallopian tube carcinoma (PFTC) is a
rare gynecologic malignancy that poses a diagnostic dilemma and is often
misdiagnosed as ovarian carcinoma, we report a case of primary high-grade
serous adenocarcinoma of the fallopian tube. This case highlights its role in
the differential diagnosis of adnexal masses and emphasizing the diagnostic
challenges and the importance of intraoperative evaluation, appropriate
treatment and follow-up.
Case Summary: A 48-year-old woman presented with watery
vaginal discharge, and on bimanual examination, a firm, non-tender mass in the
left fornix measuring 6 × 6 cm separately from the uterus. Radiological imaging
suggested an ovarian tumour, and serum CA-125 was markedly elevated at 2586
U/ml. The patient underwent staging laparotomy with total abdominal
hysterectomy, bilateral salpingo-oophorectomy, total omentectomy, and pelvic as
well as para-aortic lymphadenectomy. Intraoperatively, a solid, polypoidal
growth measuring 5 × 5 × 7 cm was identified arising from the fimbrial end of
the left fallopian tube. Approximately 100 ml of hemorrhagic peritoneal fluid
was noted in the pelvis, and two
para-aortic lymph nodes were enlarged, measuring up to 1.5 × 1 cm.
Histopathological examination confirmed a poorly differentiated serous
adenocarcinoma of the left fallopian tube, classified as histologic grade III
and nuclear grade II, and staged as pathological stage IC2.
Outcome: Postoperatively, the patient received adjuvant
chemotherapy with paclitaxel and carboplatin. She was monitored regularly over
five years with physical examinations, CA-125 testing, and imaging studies,
during which no symptoms or signs of recurrence were observed.
Author(s) Details
Gayam S.
Department of Obstetrics and Gynaecology, Vijay Marie Hospital, Hyderabad,
India.
Babu C.
Department of Surgical Oncology, Apollo Hospital, Hyderabad, India.
V.V.S. L.
Department of Obstetrics and Gynaecology, Vijay Marie Hospital, Hyderabad,
India.
Maddali S.
Histopathology & Cytology Laboratory, Hyderabad, India.
Please see the book here :- https://doi.org/10.9734/bpi/msraa/v11/6258
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