Primary choriocarcinoma of the fallopian tube: report of a case

A case of the relatively rare condition of a choriocarcinoma in the fallopian tube is presented. The patient apparently recovered completely and quantitative beta hCG assay demonstrated negative results after TAHBSO and adjuvant chemotherapy. This brings the total cases reported to 77.     

Primary adenocarcinoma of the fallopian tube. Review of the literature

An extensive review of the currently available literature on primary fallopian tube carcinoma is presented. The role of vaginal ultrasonography and the importance of an aggressive evaluation of every tubal deformity is stressed. A staging system which takes into account recent data on the biology of this malignancy is proposed. We emphasize the largely underestimated importance of early lymphatic spread of this disease, necessitating a thorough staging laparotomy with pelvic and para-aortic lymph node sampling in the apparent early stages. The need for adjuvant treatment is obvious, but until now no firm data exist as to what the optimal strategy should be. We recommend that until more representative studies are available, ovarian carcinoma protocols should be used in clinical practice.     

Primary gestational choriocarcinoma of the uterine cervix. Report of a case and review of the literature

Gestational choriocarcinoma usually arises in the uterine cavity and is associated with coincident or antecedent pregnancy. Extrauterine choriocarcinomas are very rare entities, and most of these are located in the uterine cervix. In our case, a 43-year-old woman was admitted in our hospital because she had amenorrhea for 2 months and elevated serum beta-human chorionic gonadotropin levels. The patient was considered to have an ectopic pregnancy. Initially, she was treated with methotrexate, but since there was a continuous rise in human chorionic gonadotropin levels, the patient underwent a laparoscopy, along with dilatation and curettage (D&C) of the uterine cavity. Histopathologic findings, including immunohistochemical study, led to the diagnosis of choriocarcinoma of the cervix. Finally, the patient underwent a transabdominal hysterectomy and received single agent chemotherapy with methotrexate. Our case represents a primary choriocarcinoma of the cervix, which was initially misdiagnosed as an ectopic pregnancy. The difficulties in differential diagnosis are discussed. Immunohistochemical evaluation remains the mainstay of the diagnosis in most cases. Choriocarcinoma has a very good prognosis even in advanced stages, since it is a very chemosensitive tumor.     

Primary adenocarcinoma of the fallopian tube: a case report

We report a case of a 75-year-old postmenopausal woman with primary fallopian tube carcinoma confined to the left fallopian tube in Stage IA-2, who is alive without evidence of disease three years after total abdominal hysterectomy, bilateral salpingo-oophorectomy, total omentectomy, pelvic and paraaortic lymph node dissection were performed. Histopathological examination revealed a poorly differentiated (grade 3) papillary serous adenocarcinoma of the left fallopian tube. Adjuvant irradiation was given. Primary fallopian cancer should be suspected by clinicians even if the presenting symptoms are atypical and the primary treatment remains surgical resection followed by adjuvant chemotherapy or radiation. Appropriate therapy for each stage of the disease should be defined and new studies are needed to better depict the clinical course and prognostic factors.     

Primary leiomyosarcoma of the fallopian tube: a case report

A primary leiomyosarcoma (LMS) arising from the left fallopian tube in a perimenopausal 48-year-old woman is reported. Primary tubal LMS is an uncommon, exceedingly rare neoplasm, accounting for only a few reported cases so far. To our knowledge, the present case is the 17th tubal LMS reported in the English-language literature. The diagnosis is usually made at the time of laparotomy for a pelvic or adnexal mass or other gynaecological indications. As in ovarian neoplasms, the mainstay of treatment is represented by debulking surgery consisting of total abdominal hysterectomy, bilateral salpingo-oophorectomy, random biopsies, peritoneal washing and excision of all the abdominal tumour masses. Although the approach is radical, the clinical behaviour is very poor. The role of adjuvant radio- or chemotherapy still remains unsolved.     

Primary leiomyosarcoma of the fallopian tube: Three case reports and review of the literature

Objective

Leiomyosarcoma of the fallopian tube is a rare malignant gynecologic neoplasm with poor prognosis. It is important to share experience and to collect more cases to improve the understanding of the disease.

Malignant mixed Mullerian tumor of the fallopian tube: Report of a case and review of literature

Twenty-three cases of malignant mixed Mullerian tumor of the fallopian tube have been reported; we report another such case. Type of therapy and outcome of these 24 cases is reviewed and the histogenesis is presented. Thirteen patients were treated with surgery alone, with a mean survival of 14.7 months; the longest survival was years. Nine patients were treated with surgery followed by radiation therapy, five patients died within 15 months, and the longest survivor was years. Three patients survived 12, 24, and 17 months. Our patient responded well to combination chemotherapy after surgery and survived 26 months. The small number of patients precludes conclusions on optimal therapy. Survival does not improve with postoperative radiation therapy. The potential benefit of combination chemotherapy following surgery awaits further evaluation.     

Malignant mixed Müllerian tumor of the fallopian tube: Report of a case with 5-year survival

The literature reveals a total of only 25 cases of malignant mixed Müllerian tumor of the fallopian tube. Another case is presented; the patient is well and without evidence of disease more than 5 years after the operative treatment. She also received postoperatively adjuvant cytostatic treatment with cyclophosphamide, vincristine, adriamycin, and external radiation therapy. An aggressive mode of treatment is recommended in this rare disease due to the usually very poor prognosis.     

Primary neuroendocrine carcinoma of the fallopian tube: a case report

Neuroendocrine carcinomas arise from Kulchitsky cells and are frequently seen in gastrointestinal tract and lungs. But they are unusual in gynecology practice. The Fallopian tube is one of the rarest locations for the development of a female genital malignancy. The most common histologic subtype is adenocarcinoma in malignancies of fallopian tubes, but rarely other histologic subtypes have been reported. Here we present a primary neuroendocrine carcinoma of the fallopian tube. To the best of the our knowledge, it was not reported previously.     

Primary carcinoma of the fallopian tube. A report of 19 cases with literature review

Primary carcinoma of the fallopian tube is the rarest cancer of the female genital tract with an incidence of 0.5% of all gynecologic tumors. Since the first report in 1847 about 1,500 cases have been published. Due to similarity of the clinical presentation the staging and therapeutic management have been adapted to that of ovarian cancer. We retrospectively evaluated all the 19 patients who had been diagnosed with primary carcinoma of the fallopian tube at the Department of Obstetrics and Gynecology of the University of Zurich between 1977 and 1998. All lesions were staged according to the rules of FIGO adopted in 1991. At the time of diagnosis the median age was 62 (46-87) years. Twelve (63%) women revealed FIGO stage III-IV, whereas four (21%) and three (16%) patients were diagnosed in stage I and stage II, respectively. Eight (42%) women were nullipara. Histology showed serous-papillary carcinoma, in ten (53%) cases. The 5-year survival rate was 22% for all FIGO stages and 80% for stage I. None of the patients with stage III and IV survived 5 years. Ovarian cancer and primary carcinoma of the fallopian tube are similar in many aspects. Both carcinomas have a similar age distribution, show an increase among nulliparous women, are often of serous papillary histology, have a poor prognosis with stage and residual tumor size as important prognostic factors, and respond initially well to platinum-based chemotherapy. Nevertheless, there appears to be a difference between the two diseases: primary carcinoma of the fallopian tube is more often diagnosed in an earlier stage. This many be due to lower abdominal pain resulting from tubal dilatation and to abnormal bloody-watery discharge.     

原发性输卵管肉瘤相关问题

输卵管肉瘤是非常罕见的恶性肿瘤,具有易转移和复发的特点,预后极差。常见的输卵管肉瘤包括癌肉瘤、平滑肌肉瘤、横纹肌肉瘤,以及更为少见的脂肪肉瘤及滑膜肉瘤。文章针对输卵管肉瘤的不同的病理类型介绍其诊断、治疗及预后的相关问题。     

Primary carcinoma of the fallopian tube associated with tuberculous salpingitis. A case report

A patient with co-existent carcinoma and tuberculosis of the Fallopian tube is described. Tuberculosis was diagnosed by the finding of numerous typical granulomata throughout the uterus, tubes and ovaries, and by exclusion of other possible causes of these; and carcinoma by the finding of solid tumour, with a marked anisocytic appearance, invading submucosa. Despite the well recognised epithelial hyperplasia seen in tuberculous salpingitis, there remains no evidence that the occurrence of carcinoma in such cases is other than fortuitous.     

Primary fallopian tube carcinoma - the experience of a UK cancer centre and a review of the literature.

Primary fallopian tube carcinoma (PFTC) is rare but may be under-diagnosed. We have analysed the incidence, clinical findings and outcome in patients with PFTC at the RUH Gynaecological Cancer Centre in Bath between 1999 and 2004, and compared the incidence with that of advanced ovarian carcinoma (OC). Eight patients had PFTC, seven of whom were diagnosed after 2001, and 55 patients had advanced OC. Our data suggest a relative increase in the number of patients with PFTC over the study period. PFTC patients had a mean age of 69.6 years, most presented with postmenopausal bleeding, two had a second carcinoma, three were nulliparous and none were diagnosed pre-operatively. All were treated surgically and received platinum-based chemotherapy. Although PFTC patients had better outcomes than those with advanced OC, the difference was not statistically significant (p = 0.088). Accurate diagnosis and differentiation of PFTC from advanced OC are important for monitoring trends in incidence, for better characterisation of prognostic features and improved management.     

Mixed serous and endometrioid carcinoma of the fallopian tube: a case report with literature review

Malignant neoplasms of the fallopian tube are the rarest of the gynecologic cancers. The frequency of histologic subtypes has been difficult to ascertain from the literature because most authors have not classified these tumors according to their cell types. Papillary serous adenocarcinoma appears to be the most common histologic type. On the contrary, mixed cell types of fallopian tube carcinoma have rarely been reported in the literature. A case of mixed serous and endometrioid carcinoma of the fallopian tube is presented and the related literature is reviewed.     

Primary pulmonary choriocarcinoma: case report and review of the literature

Primary pulmonary choriocarcinoma is a rare disease with only 31 reported cases in the literature so far. Here, we summarize all published cases, including a recent case of our own clinic. Patients usually presented with symptoms like dyspnea, cough, chest pain, weight loss or hemoptysis. In some cases, the nodule in the lung was found in a routine check-up in asymptomatic patients. In the present case, the patient presented to our clinic because of a positive urine pregnancy test despite taking oral contraceptives. Patients in the analyzed cases were either treated with surgery, chemotherapy, radiotherapy or best supportive care. In the present case, a complete resection of the tumor was possible and the patient has not had any signs of recurrence so far. When looking at the published cases and corresponding outcomes, a slight tendency toward a complete resection followed by chemotherapy or close follow-up examinations seems to give the patients the best survival chances. Nevertheless, the overall prognosis of primary pulmonary choriocarinoma is poor and the 5-year survival rate is below 5%.     

Primary carcinoma of the fallopian tube

The records of 50 patients with primary carcinoma of the fallopian tube referred to postoperative radiotherapy at the Radium Centre of the Finsen Institute, Copenhagen, were reviewed. The most common symptoms were postmenopausal bleeding, vaginal watery discharge and abdominal pain. In 86% of the patients a palpable pelvic tumor was found at preoperative gynecologic examination. Disease was localized to the pelvis (stage I and stage II) in nearly all patients (92%). Ten patients were given radiotherapy as vaginal radium twice combined with deep X-ray to the pelvis, and 38 patients were given radiotherapy as high-voltage irradiation to the pelvis only. The overall survival at 5 years was 50.9%. Still, the role of radiotherapy in the control of this rare disease remains to be established. To obtain a better prognosis for this disease, international cooperative prospective studies are proposed.