Primary High-Grade Serous Carcinoma of the Fallopian Tube Initially Misdiagnosed as Ovarian Carcinoma: A Case Report |Chapter 9| Medical Science: Recent Advances and Applications Vol. 11

 

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

Case Studies on Breast Malignancy with Uncommon Histology: Report of Two Cases | Chapter 2 | Current Practice in Medical Science Vol. 6

The most prevalent cancer in the world, breast carcinomas, are a burden on the planet. The most prevalent histological type of breast cancer, IDC, has established management guidelines. However, due to a lack of guidelines and a dearth of cases, the care of rare histological subtypes causes doctors headaches. Here, we provide two rare examples of breast cancer: the first is mucinous breast carcinoma, which was treated with radical MRM and adjuvant chemotherapy. Two years after the end of the course of treatment, the patient is disease-free. Primary breast lymphoma, the second type, was attempted to be treated with combined chemotherapy. After a partial response was obtained, the patient was offered radiation therapy. However, the patient refused and passed away. These two instances show the importance of standardised guidelines for a rare subtype of breast cancer. With the resources at our disposal, our study's goal was to document the response to a rather uncommon breast tumour. The therapeutic success for these patients may be improved with more case series and prospective trials.

 

Author (s) Details

Diptajit Paul

Department of Radiation Oncology, Pt B D Sharma PGIMS, Rohtak, Haryana, India.

Sheeba Bhardwaj

Department of Radiation Oncology, Pt B D Sharma PGIMS, Rohtak, Haryana, India.

Rakesh Dhankhar

Department of Radiation Oncology, Pt B D Sharma PGIMS, Rohtak, Haryana, India.

Vivek Kaushal

Department of Radiation Oncology, Pt B D Sharma PGIMS, Rohtak, Haryana, India.

 

 

View Book :-  https://stm.bookpi.org/CPMS-V6/article/view/7675

Surgery for Colorectal Cancer Improves Survival in Uganda: A Cohort Study | Chapter 1 | Current Practice in Medical Science Vol. 4

While colorectal cancer (CRC) rates are down in high-income industrialised nations, they are increasing in Uganda and other emerging low-income countries in Sub-Saharan Africa. Many CRC patients in Uganda lack access to oncological treatment or curative surgery. We compared the survival rates of patients who got curative surgery and, if necessary, adjuvant chemotherapy to those who did not in order to examine the impact of surgery and oncology care on CRC in the resource-constrained setting of a low-income developing country. People who received a CRC diagnosis between January 1, 2008, and December 31, 2018, were included in the research. For these individuals, the medical data from Ugandan hospitals were connected with the Kampala Cancer Registry. If the patients had undergone adjuvant therapy in addition to curative surgery, the researchers wanted to know. Three-year survival was our outcome variable. The calculation and comparison of survival were done using the log-rank test. The research covered 247 patients in total. 70 patients (28.34 percent) did not get curative surgery whereas there were 177 (71.66%) people who did. The survival rate after curative surgery for rectal cancer was higher (p=0.003). In general, patients who underwent surgery for their colon cancer were more likely to survive (p=0.137). In comparison to no surgery and no adjuvant chemotherapy, curative surgery and adjuvant chemotherapy demonstrated higher survival (p=0.007). In a circumstance when resources are limited, curative surgery, if required, combined with adjuvant chemotherapy enhances survival. The results of our study support the expansion of CRC care through upgrading surgery and oncology facilities in resource-constrained locations as a result of the rising prevalence of CRC.

Author(s) Details:

Richard Wismayer,

Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda and Department of Surgery, Faculty of Health Sciences, Habib Medical School, IUIU University, Kampala, Uganda and Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.

Julius Kiwanuka,

Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.

Henry Wabinga,

Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.

Michael Odida,

Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda and  Department of Pathology, Faculty of Medicine, Gulu University, Gulu, Uganda.

Please see the link here: https://stm.bookpi.org/CPMS-V4/article/view/7356