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Scioscia M, Virgilio BA, Sacchi D, Iaria L, Guerriero S. Fallopian tube entrapped within inflammatory or endometriotic ovarian cyst may mimic malignancy. Ultrasound Obstet Gynecol 2022; 59:399-401. [PMID: 34159672 DOI: 10.1002/uog.23716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 06/14/2021] [Indexed: 06/13/2023]
Affiliation(s)
- M Scioscia
- Unit of Gynecological Surgery, Mater Dei Hospital, Bari, Italy
- Department of Obstetrics and Gynecology, Policlinico of Abano Terme, Abano Terme, Padua, Italy
| | - B A Virgilio
- Department of Obstetrics and Gynecology, Policlinico of Abano Terme, Abano Terme, Padua, Italy
| | - D Sacchi
- Department of Medicine (DIMED), Surgical Pathology Unit, University of Padova, Padua, Italy
| | - L Iaria
- Department of Pathology, Policlinico of Abano Terme, Abano Terme, Padua, Italy
| | - S Guerriero
- Department of Obstetrics and Gynecology, University of Cagliari, Cagliari, Italy
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Sumtsov DH, Gladchuk IZ, Kashtalian NM, Sumtsov GO. PRACTICAL MEANS OF PREOPERATIVE DIAGNOSTICS OF PRIMARY FALLOPIAN TUBE CANCER. Wiad Lek 2021; 74:282-287. [PMID: 33813487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The aim: To analyze contemporary practical means to improve diagnostics of primary fallopian tube cancer. PATIENTS AND METHODS Materials and methods: Authors analyzed specifics of clinical signs and anamnesis in 152 PFTC patients. Diagnostic capacity of cytological analysis of pathologic vaginal discharge, X-ray contrast methods of examination, sonography, tumor markers, and computed tomography was studied. Own results of PFTC diagnostics using different methods and world practice using MRI, PET-CT and laparoscopy were discussed. RESULTS Results: Using own observations authors conclude that clinical analysis and complex use of the listed methods allows to mainly determine high risk group patients and set correct preoperative diagnosis in 35% and preliminary diagnosis in 20% of PFTC patients. CONCLUSION Conclusions: Complex examination allows to recognize primary fallopian tube cancer on preoperative stage and to avoid inadequate surgical interventions in majority of PFTC patients.
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Lee DH, Cho DH, Kim KM, Yim CY, Lee NR. Primary transitional cell carcinoma of the fallopian tube: A case report and literature review. Medicine (Baltimore) 2020; 99:e20499. [PMID: 32481467 DOI: 10.1097/md.0000000000020499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Primary transitional cell carcinoma (TCC) of the fallopian tube is an extremely rare tumor. PATIENT CONCERNS A 79-year-old woman presenting with vaginal discharge. DIAGNOSIS Pelvic magnetic resonance imaging revealed a predominantly solid mass with a lobulated contour, measuring 5.5 cm × 4.6 cm, in the left ovary. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. Pathological analysis revealed a high-grade TCC, measuring 7.5 cm × 4 cm, in the left fallopian tube (International Federation of Gynecology and Obstetrics stage IIB). INTERVENTION Forty-three months postoperation, recurrence was diagnosed as peritoneal metastasis. The patient underwent 6 cycles of palliative chemotherapy consisting of cisplatin and gemcitabine, the recommended regimen for TCC of the urinary tract. OUTCOME The patient has survived for 27 months without recurrence after palliative chemotherapy, 76 months after diagnosis. CONCLUSION It is rare that primary TCC of the fallopian tube responds to a urinary tract treatment regimen for TCC, even when followed up for an extended period. More research is warranted to determine which treatment regimen will benefit patients the most.
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Affiliation(s)
- Dong-Hyun Lee
- Department of Obstetrics and Gynecology, Jeonbuk National University Hospital-Jeonbuk National University Medical School
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital
| | - Dong-Hyu Cho
- Department of Obstetrics and Gynecology, Jeonbuk National University Hospital-Jeonbuk National University Medical School
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital
| | - Kyoung Min Kim
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital
- Department of Pathology
| | - Chang-Yeol Yim
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital
- Division of Hematology and oncology, Department of Internal Medicine, Jeonbuk National University Hospital-Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Na-Ri Lee
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital
- Division of Hematology and oncology, Department of Internal Medicine, Jeonbuk National University Hospital-Jeonbuk National University Medical School, Jeonju, Republic of Korea
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Peeraully R, Henderson K, Fairbrother K, Patel R, Fraser N, Shenoy M, Williams A. Effect of Surgical Specialty on Management of Adnexal Masses in Children and Adolescents: An 8-Year Single-Center Review. J Pediatr Adolesc Gynecol 2020; 33:89-92. [PMID: 31254617 DOI: 10.1016/j.jpag.2019.06.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 06/18/2019] [Accepted: 06/20/2019] [Indexed: 02/08/2023]
Abstract
STUDY OBJECTIVE Children with adnexal masses might be managed by pediatric surgeons, urologists or gynecologists, with the potential for different management strategies between specialties. In this study we compared ovarian conservation rates and surgical approach for adnexal masses in children and adolescents managed either by pediatric surgeons/urologists or gynecologists at a tertiary care institution. DESIGN Retrospective cohort review. SETTING Tertiary pediatric and adult university hospital. PARTICIPANTS Patients younger than 18 years of age with an adnexal mass managed surgically with removal of histologically confirmed ovarian or fallopian tube tissue from 2008 to 2015. INTERVENTIONS Laparoscopic or open procedure for adnexal mass. MAIN OUTCOME MEASURES The primary outcome was rate of ovarian conservation relative to surgical specialty. The secondary outcome was surgical approach relative to surgical specialty. RESULTS Forty-eight patients underwent surgery for adnexal masses; 26 (54%) under pediatric surgery/urology and 22 (46%) under gynecology care. Laparoscopy was performed in 5 (19%) pediatric and 19 (86%) gynecology cases (P = .000006). Of 24 patients older than 12 years of age with a benign tumor, 10 (42%) underwent procedures resulting in loss of an ovary with or without fallopian tube; 8 of these (80%) were under pediatric care. Of the remaining 14 (58%) who underwent ovarian conserving surgery, 12 (80%) were under gynecology care (P = .0027). CONCLUSION Patients with a benign tumor were significantly more likely to undergo ovary-preserving surgery under gynecology care than under pediatric surgery/urology care. A multidisciplinary team approach involving gynecology and pediatric surgical specialties would be valuable in assessing the merits of ablative or conservative surgery in each case.
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Affiliation(s)
- Riyad Peeraully
- Department of Pediatric Urology, Nottingham Children's Hospital, Queens Medical Centre, Nottingham, United Kingdom
| | - Katrina Henderson
- Department of Pediatric Urology, Nottingham Children's Hospital, Queens Medical Centre, Nottingham, United Kingdom
| | - Kristina Fairbrother
- Department of Pediatric Urology, Nottingham Children's Hospital, Queens Medical Centre, Nottingham, United Kingdom
| | - Ramnik Patel
- Department of Pediatric Urology, Nottingham Children's Hospital, Queens Medical Centre, Nottingham, United Kingdom
| | - Nia Fraser
- Department of Pediatric Urology, Nottingham Children's Hospital, Queens Medical Centre, Nottingham, United Kingdom
| | - Manoj Shenoy
- Department of Pediatric Urology, Nottingham Children's Hospital, Queens Medical Centre, Nottingham, United Kingdom
| | - Alun Williams
- Department of Pediatric Urology, Nottingham Children's Hospital, Queens Medical Centre, Nottingham, United Kingdom.
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Abstract
RATIONALE Hepatoid adenocarcinoma (HAC) of the fallopian tubes is a rare malignant tumor in the female reproductive system. PATIENT CONCERNS An 81-year-old Chinese woman presented with an elevated serum alpha-fetoprotein (AFP) level. DIAGNOSIS Positron emission tomography-computed tomography (PET-CT) scan revealed a mass of approximately 47 × 27 mm located in the right adnexa. The tumor was diagnosed as a HAC arising from fallopian tube by immunohistochemical and histochemical technique. INTERVENTIONS This patient underwent surgical treatment including a bilateral adnexectomy and appendectomy. In addition, the patient underwent 5 cycles of postoperative chemotherapy. OUTCOMES The disease has recurred approximately six months after surgery and therefore, this patient will continue to be observed. LESSONS Up to this point, only 4 known cases of HAC originating in fallopian tube have been published in the English literature. Further studies are needed to better understand the clinical characteristics, the prognosis, and the pathological mechanism of HAC development in the fallopian tubes.
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Affiliation(s)
- Maomao Li
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education
| | - Kaixuan Yang
- Department of Pathology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ping Wang
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education
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Thomassin-Naggara I, Daraï E, Lécuru F, Fournier L. [Diagnostic value of imaging (ultrasonography, doppler, CT, MR, PET-CT) for the diagnosis of a suspicious ovarian mass and staging of ovarian, tubal or primary peritoneal cancer: Article drafted from the French Guidelines in oncology entitled "Initial management of patients with epithelial ovarian cancer" developed by FRANCOGYN, CNGOF, SFOG, GINECO-ARCAGY under the aegis of CNGOF and endorsed by INCa]. ACTA ACUST UNITED AC 2019; 47:123-133. [PMID: 30686729 DOI: 10.1016/j.gofs.2018.12.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Indexed: 11/18/2022]
Abstract
Transvaginal ultrasound is the first-line examination allowing characterizing 80 to 90% of adnexal masses (LP1). If performed by an expert, a subjective analysis is optimal. If performed by a non-expert, combining the use of Simple Rules with subjective analysis can achieve the diagnostic performance of an expert (LP1). Whichever the chosen model (subjective analysis by an expert or combination of the Simple Rules with a subjective analysis by a non-expert), a second-line examination will have to be proposed in the complex or indeterminate cases (about 20% of the masses) (grade A). The best-performing second-line test for characterization is pelvic MRI (LP1). If read by an expert, a pathological hypothesis can or should be suggested (grade D). In case of non-expert reading, the use of the ADNEXMR score allows a reliable assessment of the positive predictive value of malignancy to guide the patient towards the best management (gradeC). For preoperative assessment and evaluation of resectability of ovarian, fallopian tube or primary peritoneal cancer, it is recommended to perform a chest abdomen and pelvis CT with contrast agent injection (LP2, grade B). In the event of a contraindication to the injection of iodinated contrast agent (severe renal insufficiency, GFR <30mL/min), an abdomen and pelvis MRI completed with a non-injected chest CT may be proposed (LP3, grade C). By analogy, the same examinations are recommended to evaluate the disease after neo-adjuvant chemotherapy (LP3, Recommendation grade C). Further studies will be required to determine whether PET-CT provides better lymph node assessment before retroperitoneal and pelvic lymphadenectomy. PET-CT may be used to eliminate lymph node involvement in the absence of suspicious lymph nodes on morphological examination (LP3, grade C). The report should specify the localizations leading to a risk of incomplete cytoreductive surgery and lesions outside the field explored during surgery.
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Affiliation(s)
- I Thomassin-Naggara
- Service de radiologie, hôpital Tenon, Assistance publique-Hôpitaux de Paris (AP-HP), 4, rue de la Chine, 75020 Paris, France; Équipe medecine- Jussieu, institut des sciences du calcul et de données (ISCD), Sorbonne université 4, place Jussieu, 75006 Paris, France.
| | - E Daraï
- Service de gynécologie et obstétrique, hôpital Tenon, Assistance publique-Hôpitaux de Paris (AP-HP), 4, rue de la Chine, 75020 Paris, France
| | - F Lécuru
- Service de chirurgie cancérologique gynécologique et du sein, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France
| | - L Fournier
- Service de radiologie, université Paris Descartes Sorbonne Paris Cité, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France; Université Paris Descartes Sorbonne Paris Cité, Inserm UMR-S970, Cardiovascular Research Center - PARCC, 56, rue Leblanc, 75015 Paris, France
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Roze JF, Hoogendam JP, van de Wetering FT, Spijker R, Verleye L, Vlayen J, Veldhuis WB, Scholten RJPM, Zweemer RP. Positron emission tomography (PET) and magnetic resonance imaging (MRI) for assessing tumour resectability in advanced epithelial ovarian/fallopian tube/primary peritoneal cancer. Cochrane Database Syst Rev 2018; 10:CD012567. [PMID: 30298516 PMCID: PMC6517226 DOI: 10.1002/14651858.cd012567.pub2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Ovarian cancer is the leading cause of death from gynaecological cancer in developed countries. Surgery and chemotherapy are considered its mainstay of treatment and the completeness of surgery is a major prognostic factor for survival in these women. Currently, computed tomography (CT) is used to preoperatively assess tumour resectability. If considered feasible, women will be scheduled for primary debulking surgery (i.e. surgical efforts to remove the bulk of tumour with the aim of leaving no visible (macroscopic) tumour). If primary debulking is not considered feasible (i.e. the tumour load is too extensive), women will receive neoadjuvant chemotherapy to reduce tumour load and subsequently undergo (interval) surgery. However, CT is imperfect in assessing tumour resectability, so additional imaging modalities can be considered to optimise treatment selection. OBJECTIVES To assess the diagnostic accuracy of fluorodeoxyglucose-18 (FDG) PET/CT, conventional and diffusion-weighted (DW) MRI as replacement or add-on to abdominal CT, for assessing tumour resectability at primary debulking surgery in women with stage III to IV epithelial ovarian/fallopian tube/primary peritoneal cancer. SEARCH METHODS We searched MEDLINE and Embase (OVID) for potential eligible studies (1946 to 23 February 2017). Additionally, ClinicalTrials.gov, WHO-ICTRP and the reference list of all relevant studies were searched. SELECTION CRITERIA Diagnostic accuracy studies addressing the accuracy of preoperative FDG-PET/CT, conventional or DW-MRI on assessing tumour resectability in women with advanced stage (III to IV) epithelial ovarian/fallopian tube/primary peritoneal cancer who are scheduled to undergo primary debulking surgery. DATA COLLECTION AND ANALYSIS Two authors independently screened titles and abstracts for relevance and inclusion, extracted data and performed methodological quality assessment using QUADAS-2. The limited number of studies did not permit meta-analyses. MAIN RESULTS Five studies (544 participants) were included in the analysis. All studies performed the index test as replacement of abdominal CT. Two studies (366 participants) addressed the accuracy of FDG-PET/CT for assessing incomplete debulking with residual disease of any size (> 0 cm) with sensitivities of 1.0 (95% CI 0.54 to 1.0) and 0.66 (95% CI 0.60 to 0.73) and specificities of 1.0 (95% CI 0.80 to 1.0) and 0.88 (95% CI 0.80 to 0.93), respectively (low- and moderate-certainty evidence). Three studies (178 participants) investigated MRI for different target conditions, of which two investigated DW-MRI and one conventional MRI. The first study showed that DW-MRI determines incomplete debulking with residual disease of any size with a sensitivity of 0.94 (95% CI 0.83 to 0.99) and a specificity of 0.98 (95% CI 0.88 to 1.00) (low- and moderate-certainty evidence). For abdominal CT, the sensitivity for assessing incomplete debulking was 0.66 (95% CI 0.52 to 0.78) and the specificity 0.77 (95% CI 0.63 to 0.87) (low- and low-certainty evidence). The second study reported a sensitivity of DW-MRI of 0.75 (95% CI 0.35 to 0.97) and a specificity of 0.96 (95% CI 0.80 to 1.00) (very low-certainty evidence) for assessing incomplete debulking with residual disease > 1 cm. In the last study, the sensitivity for assessing incomplete debulking with residual disease of > 2 cm on conventional MRI was 0.91 (95% CI 0.59 to 1.00) and the specificity 0.97 (95% CI 0.87 to 1.00) (very low-certainty evidence). Overall, the certainty of evidence was very low to moderate (according to GRADE), mainly due to small sample sizes and imprecision. AUTHORS' CONCLUSIONS Studies suggested a high specificity and moderate sensitivity for FDG-PET/CT and MRI to assess macroscopic incomplete debulking. However, the certainty of the evidence was insufficient to advise routine addition of FDG-PET/CT or MRI to clinical practice..In a research setting, adding an alternative imaging method could be considered for women identified as suitable for primary debulking by abdominal CT, in an attempt to filter out false-negatives (i.e. debulking, feasible based on abdominal CT, unfeasible at actual surgery).
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Affiliation(s)
- Joline F Roze
- UMC Utrecht Cancer CenterDepartment of Gynaecological OncologyUtrechtNetherlands3508 GA
| | - Jacob P Hoogendam
- UMC Utrecht Cancer CenterDepartment of Gynaecological OncologyUtrechtNetherlands3508 GA
| | - Fleur T van de Wetering
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht UniversityCochrane NetherlandsPO Box 85500UtrechtNetherlands3508 GA
| | - René Spijker
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht UniversityCochrane NetherlandsPO Box 85500UtrechtNetherlands3508 GA
| | - Leen Verleye
- Belgian Health Care Knowledge CentreKruidtuinlaan 55BrusselsBelgium1000
| | - Joan Vlayen
- Belgian Health Care Knowledge CentreKruidtuinlaan 55BrusselsBelgium1000
| | - Wouter B Veldhuis
- University Medical Center UtrechtDepartment of RadiologyRoom E01.132PO Box 85500UtrechtNetherlands3508 GA
| | - Rob JPM Scholten
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht UniversityCochrane NetherlandsPO Box 85500UtrechtNetherlands3508 GA
| | - Ronald P Zweemer
- UMC Utrecht Cancer CenterDepartment of Gynaecological OncologyUtrechtNetherlands3508 GA
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Abstract
Background Because of the rarity of fallopian tubecancer, clinical approaches have changed during the last 18 years. Methods Twenty-nine patients with fallopian tube cancer were treated at the Gynecologic Oncology Department of Milan University from 1970 to 1988. The mean patient age was 59 years. Parity, symptomatology and histology were considered. Distribution by stage was as follows: I, 11 (37 %); II, 10 (34 %); III, 8 (27%) according to the Dodson classification. Twenty patients (69 %) underwent surgery followed by pelvic irradiation. Adjuvant chemotherapy was performed in the treatment of 5 women with stage I disease, 6 with stage II, and all 8 with stage III. Results Five-year overall survival was 41.38 %: 47.6% at stages I and II, 25% at stage III. Radiotherapy has not been replaced by cisplatin-based multiagent chemotherapy. Optimal surgical debulking combined with accurate lymph node sampling are not followed by systematic use of repeat laparotomy. Conclusions The procedures described in this work improve the clinical assessment and patient survival, and make different series comparable.
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Affiliation(s)
- L Frigerio
- IIIa Clinica di Ostetricia e Ginecologia, Università degli Studi di Milano, Istituto Scientifico S. Raffaele, Italy
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Balaya V, Metzger U, Denet C, Herry M, Lecuru F. Isolated fallopian tube metastasis from colorectal cancer: ultrasonographic features. J Ultrasound 2018; 21:69-75. [PMID: 29374394 DOI: 10.1007/s40477-017-0258-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 05/31/2017] [Indexed: 11/26/2022] Open
Abstract
We present here the first-reported case of tubal metastasis from colorectal cancer diagnosed by a preoperative pelvic ultrasound. A 53-year-old woman suffering from vaginal discharge was referred to us 2 years after she underwent a partial colectomy for adenocarcinoma. The pelvic ultrasound examination revealed a right pelvic mass of 52 × 24 × 38 mm, independent of the right ovary, which was apparently unaffected. A right salpingo-oophorectomy was performed and the definitive histopathology examination showed a recurrence of the initial adenocarcinoma with a right tubal metastasis. The eventuality of such an unusual site of metastasis should be remembered.
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Affiliation(s)
- V Balaya
- Service de Chirurgie cancérologique, gynécologique et du sein, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75908, Paris Cedex 15, France.
- URDIA Anatomie EA 4465, 45, Rue des Saints-Pères, 75006, Paris, France.
- Faculté de médecine, Université Paris Descartes, 15 rue de l'Ecole de Médecine, 75006, Paris, France.
| | - U Metzger
- Service de Chirurgie cancérologique, gynécologique et du sein, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75908, Paris Cedex 15, France
| | - C Denet
- Service de Chirurgie générale et digestive, Institut Mutualiste de Montsouris, 42 Boulevard Jourdan, 75014, Paris, France
| | - M Herry
- Service de Chirurgie gynécologique, Institut Mutualiste de Montsouris, 42 Boulevard Jourdan, 75014, Paris, France
| | - F Lecuru
- Service de Chirurgie cancérologique, gynécologique et du sein, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75908, Paris Cedex 15, France
- Faculté de médecine, Université Paris Descartes, 15 rue de l'Ecole de Médecine, 75006, Paris, France
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Liu YW, Du YF, Zhang HZ, Fang GY, Zhang YX, Ge J, Liu J. Evaluation of Short-Term Efficacy of Concurrent Chemoradiotherapy in Primary Fallopian Tube Carcinoma by Diffusion-Weighted Imaging: A Retrospective Study. Oncol Res Treat 2017; 40:281-287. [PMID: 28423375 DOI: 10.1159/000464354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 02/21/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND This study aims to evaluate the short-term efficacy of concurrent chemoradiotherapy (CCRT) in primary fallopian tube carcinoma (PFTC) using magnetic resonance diffusion-weighted imaging (MR-DWI). PATIENTS AND METHODS Total abdominal irradiation was performed for 61 PFTC patients after surgery, and paclitaxel and carboplatin were used for CCRT. According to the response evaluation criteria in solid tumors (RECIST1.1), patients were divided into a sensitive (n = 36) and a resistant group (n = 25). Pearson correlation analysis was conducted to assess the correlations of tumor regression rate with apparent diffusion coefficient (ADC)pre, ADCpost, and ∆ADCpost. The efficacy of CCRT in PFTC using MR-DWI was evaluated by ROC curve, logistic regression analysis, Kaplan-Meier survival curve, and Cox regression model. RESULTS The ADCpre in both the sensitive and the resistant group was negatively associated with the tumor regression rate (r = -0.508), while the ADCpost (r = 0.454) and ∆ADCpost (r = 0.769) were positively associated with the tumor regression rate (all p < 0.05). Histopathological type, FIGO stage, lymphatic metastasis, tumor regression rate, ADCpre, ADCpost, and ∆ADCpost were confirmed as key factors for CCRT in PFTC (all p < 0.05). CONCLUSION Our retrospective study demonstrates the predictive value of MR-DWI in CCRT for PFTC patients.
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Borley J, Wilhelm-Benartzi C, Yazbek J, Williamson R, Bharwani N, Stewart V, Carson I, Hird E, McIndoe A, Farthing A, Blagden S, Ghaem-Maghami S. Radiological predictors of cytoreductive outcomes in patients with advanced ovarian cancer. BJOG 2015; 122:843-849. [PMID: 25132394 DOI: 10.1111/1471-0528.12992] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess site of disease on preoperative computed tomography (CT) to predict surgical debulking in patients with ovarian cancer. DESIGN Two-phase retrospective cohort study. SETTING West London Gynaecological Cancer Centre, UK. POPULATION Women with stage 3 or 4, ovarian, fallopian or primary peritoneal cancer undergoing cytoreductive surgery. METHODS Preoperative CT images were reviewed by experienced radiologists to assess the presence or absence of disease at predetermined sites. Multivariable stepwise logistic regression models determined sites of disease which were significantly associated with surgical outcomes in the test (n = 111) and validation (n = 70) sets. MAIN OUTCOME MEASURES Sensitivity and specificity of CT in predicting surgical outcome. RESULTS Stepwise logistic regression identified that the presence of lung metastasis, pleural effusion, deposits on the large-bowel mesentery and small-bowel mesentery, and infrarenal para-aortic nodes were associated with debulking status. Logistic regression determined a surgical predictive score which was able to significantly predict suboptimal debulking (n = 94, P = 0.0001) with an area under the curve (AUC) of 0.749 (95% confidence interval [95% CI]: 0.652, 0.846) and a sensitivity of 69.2%, specificity of 71.4%, positive predictive value of 75.0% and negative predictive value of 65.2%. These results remained significant in a recent validation set. There was a significant difference in residual disease volume in the test and validation sets (P < 0.001) in keeping with improved optimal debulking rates. CONCLUSIONS The presence of disease at some sites on preoperative CT scan is significantly associated with suboptimal debulking and may be an indication for a change in surgical planning.
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Affiliation(s)
- J Borley
- Department of Surgery and Cancer, Imperial College London, London, UK
| | | | - J Yazbek
- West London Gynaecology Cancer Centre, Imperial College NHS Trust, London, UK
| | - R Williamson
- West London Gynaecology Cancer Centre, Imperial College NHS Trust, London, UK
- Department of Radiology, Imperial College Healthcare NHS Trust, London, UK
| | - N Bharwani
- West London Gynaecology Cancer Centre, Imperial College NHS Trust, London, UK
- Department of Radiology, Imperial College Healthcare NHS Trust, London, UK
| | - V Stewart
- West London Gynaecology Cancer Centre, Imperial College NHS Trust, London, UK
- Department of Radiology, Imperial College Healthcare NHS Trust, London, UK
| | - I Carson
- West London Gynaecology Cancer Centre, Imperial College NHS Trust, London, UK
| | - E Hird
- West London Gynaecology Cancer Centre, Imperial College NHS Trust, London, UK
| | - A McIndoe
- West London Gynaecology Cancer Centre, Imperial College NHS Trust, London, UK
| | - A Farthing
- Department of Surgery and Cancer, Imperial College London, London, UK
- West London Gynaecology Cancer Centre, Imperial College NHS Trust, London, UK
| | - S Blagden
- Department of Surgery and Cancer, Imperial College London, London, UK
- West London Gynaecology Cancer Centre, Imperial College NHS Trust, London, UK
| | - S Ghaem-Maghami
- Department of Surgery and Cancer, Imperial College London, London, UK
- West London Gynaecology Cancer Centre, Imperial College NHS Trust, London, UK
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Radosa MP, Vorwergk J, Fitzgerald J, Kaehler C, Schneider U, Camara O, Runnebaum IB, Schleußner E. Sonographic discrimination between benign and malignant adnexal masses in premenopause. Ultraschall Med 2014; 35:339-344. [PMID: 23775448 DOI: 10.1055/s-0033-1335728] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE The aim of this study was to assess the diagnostic value of sonographic pattern recognition by experts, a standardized morphological scoring system, the risk malignancy index (RMI) and CA 125 assay for the preoperative assessment of ovarian lesions in premenopausal patients. MATERIAL AND METHODS Diagnostic work-up of 1320 patients who underwent surgical exploration due to an adnexal mass at a tertiary referral center were included. We assessed the discriminative value of pattern recognition, a sonographic morphological scoring system, RMI and CA 125 by calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and Cohen's kappa for each diagnostic approach while using histopathology as the reference standard. RESULTS Pattern recognition showed the highest discriminative power with an observed kappa of 0.53. Sensitivity and specificity yielded 0.76 and 0.97 respectively. Combining pattern recognition with CA 125 serum measurement in the context of a triage system diminished the diagnostic value (kappa: 0.24; sensitivity: 0.29 specificity: 0.97). For the RMI we observed a sensitivity of 0.54 and a specificity of 0.96 and estimated kappa value yielded 0.37. Omitting the CA 125 assay and using a morphological sonographic assessment system increased the kappa value to 0.45 with sensitivity and specificity observed at 0.61 and 0.97 respectively. CONCLUSION Expert pattern recognition was found to be the method with the highest discriminative power in assessing an adnexal mass during premenopause. Additional assessment of serum CA 125 diminished the diagnostic accuracy. Standardized morphological sonographic assessment resulted in a moderate diagnostic accuracy. Supplementing the morphological sonographic assessment with CA 125 by using the RMI algorithm did not improve the diagnostic value.
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Affiliation(s)
- M P Radosa
- Gynecology and Obstetrics, Jena Universtiy Hospital, Jena
| | - J Vorwergk
- Gynecology and Obstetrics, Jena Universtiy Hospital, Jena
| | - J Fitzgerald
- Gynecology and Obstetrics, Jena Universtiy Hospital, Jena
| | - C Kaehler
- Praxis Prof. Dr. Kaehler, Praenatologische Schwerpunktpraxis Erfurt
| | - U Schneider
- Gynecology and Obstetrics, Jena Universtiy Hospital, Jena
| | - O Camara
- Gynecology and Obstetrics, Jena Universtiy Hospital, Jena
| | - I B Runnebaum
- Gynecology and Obstetrics, Jena Universtiy Hospital, Jena
| | - E Schleußner
- Abteilung Geburtshilfe, Universitätsfrauenklinik, Jena
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13
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Ludovisi M, De Blasis I, Virgilio B, Fischerova D, Franchi D, Pascual MA, Savelli L, Epstein E, Van Holsbeke C, Guerriero S, Czekierdowski A, Zannoni G, Scambia G, Jurkovic D, Rossi A, Timmerman D, Valentin L, Testa AC. Imaging in gynecological disease (9): clinical and ultrasound characteristics of tubal cancer. Ultrasound Obstet Gynecol 2014; 43:328-335. [PMID: 23893713 DOI: 10.1002/uog.12570] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 07/15/2013] [Accepted: 07/16/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVES To describe clinical history and ultrasound findings in patients with tubal carcinoma. METHODS Patients with a histological diagnosis of tubal cancer who had undergone preoperative ultrasound examination were identified from the databases of 13 ultrasound centers. The tumors were described by the principal investigator at each contributing center on the basis of ultrasound images, ultrasound reports and research protocols (when applicable) using the terms and definitions of the International Ovarian Tumor Analysis (IOTA) group. In addition, three authors reviewed together all available digital ultrasound images and described them using subjective evaluation of gray-scale and color Doppler ultrasound findings. RESULTS We identified 79 women with a histological diagnosis of primary tubal cancer, 70 of whom (89%) had serous carcinomas and 46 (58%) of whom presented at FIGO stage III. Forty-nine (62%) women were asymptomatic (incidental finding), whilst the remaining 30 complained of abdominal bloating or pain. Fifty-three (67%) tumors were described as solid at ultrasound examination, 14 (18%) as multilocular solid, 10 (13%) as unilocular solid and two (3%) as unilocular. No tumor was described as a multilocular mass. Most tumors (70/79, 89%) were moderately or very well vascularized on color or power Doppler ultrasound. Normal ovarian tissue was identified adjacent to the tumor in 51% (39/77) of cases. Three types of ultrasound appearance were identified as being typical of tubal carcinoma using pattern recognition: a sausage-shaped cystic structure with solid tissue protruding into it like a papillary projection (11/62, 18%); a sausage-shaped cystic structure with a large solid component filling part of the cyst cavity (13/62, 21%); an ovoid or oblong completely solid mass (36/62, 58%). CONCLUSIONS A well vascularized ovoid or sausage-shaped structure, either completely solid or with large solid component(s) in the pelvis, should raise the suspicion of tubal cancer, especially if normal ovarian tissue is seen adjacent to it.
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Affiliation(s)
- M Ludovisi
- Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
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14
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Hviid MM, Teklay B, Jensen PT. [Atypical debut of symptoms of fallopian tube cancer]. Ugeskr Laeger 2013; 175:2114-2115. [PMID: 24011209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Fallopian tube cancer is rare and accounts for 0.3-1% of all gynaecological cancers. We describe a case of undiagnosed fallopian tube cancer presenting as a swollen inguinal lymph node and later diagnosed with PET-CT. Final histology revealed a serous adenocarcinoma of the fallopian tube with metastases to both ovaries and one inguinal lymph node. Recent studies suggest that serous borderline tumour of the ovaries originate from the fallopian tubes. The present case confirms this hypothesis. PET-CT is an important tool in diagnosing ovarian and fallopian tube cancers.
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15
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Burger RA, Brady MF, Rhee J, Sovak MA, Kong G, Nguyen HP, Bookman MA. Independent radiologic review of the Gynecologic Oncology Group Study 0218, a phase III trial of bevacizumab in the primary treatment of advanced epithelial ovarian, primary peritoneal, or fallopian tube cancer. Gynecol Oncol 2013; 131:21-6. [PMID: 23906656 DOI: 10.1016/j.ygyno.2013.07.100] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Revised: 07/18/2013] [Accepted: 07/21/2013] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Gynecologic Oncology Group Study 0218 (GOG-0218), a phase III, placebo-controlled trial in newly diagnosed stage III/IV ovarian cancer (OC), demonstrated a benefit in investigator (INV)-assessed progression-free survival (PFS) with bevacizumab (BEV) administered with and following carboplatin/paclitaxel (CP) for up to 15 months vs. CP alone. To determine the reliability of Response Evaluation Criteria in Solid Tumors (RECIST) in assessing disease progression (PD) in GOG-0218, an independent review of radiologic and clinical data (IRC) was conducted. METHODS Blinded reviews followed RECIST 1.0 in accordance with the study protocol; PFS was analyzed in the intent-to-treat population. RESULTS CP+BEV→BEV achieved a significant PFS improvement in both assessments. Hazard ratios for PFS (IRC: 0.623; 95% confidence interval [CI]: 0.503-0.772; p<0.0001 vs. INV: 0.624; 95% CI: 0.520-0.749; p<0.0001) and the improvement in median PFS (IRC: 19.1 and 13.1 months vs. INV: 18.2 and 12 months) were similar between IRC and INV assessments. There was high concordance between IRC- and INV-determined PD status (77%) and date (73%). Subgroup analyses were consistent with the primary IRC findings. Early and late discontinuation discordance measures showed no evidence of INV bias. CONCLUSION IRC analysis confirmed a significant PFS improvement with CP+BEV→BEV vs. CP alone. Concordance was not influenced by extent of residual disease after cytoreductive surgery or initial stage. The IRC size, high participation rate, and strong concordance between IRC and INV assessments suggest that RECIST can be applied objectively in OC studies.
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16
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Savelli L, Fabbri F, Moruzzi C, Testa AC. Misdiagnosed ectopic pregnancy mimicking adnexal malignancy: a report of two cases. Ultrasound Obstet Gynecol 2013; 41:223-225. [PMID: 22744800 DOI: 10.1002/uog.11220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/01/2012] [Indexed: 06/01/2023]
Abstract
We present two cases of nulliparous women with no history of amenorrhea who were referred to our unit following finding of a hypervascularized solid adnexal mass. In both cases a malignant tumor of tubal origin was suspected at transvaginal sonography. However, following laparoscopy, histological examination revealed that the masses were the result of an undetected tubal ectopic pregnancy that had failed spontaneously, with massive vasodilatation of pelvic blood vessels surrounding the trophoblastic tissue. We recommend consideration of the potential diagnosis of a previously undetected, failed tubal ectopic pregnancy in fertile women presenting with an adnexal mass, even when there is no history of amenorrhea or a positive pregnancy test.
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Affiliation(s)
- L Savelli
- Gynecology and Early Pregnancy Ultrasound Unit, S. Orsola - Malpighi Hospital, University of Bologna, Bologna, Italy.
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17
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Loubeyre P, Patel S, Copercini M, Petignat P, Dallenbach P, Dubuisson JB. Role of sonography in the diagnostic workup of ovarian and adnexal masses except in pregnancy and during ovarian stimulation. J Clin Ultrasound 2012; 40:424-432. [PMID: 22729945 DOI: 10.1002/jcu.21959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2011] [Accepted: 05/07/2012] [Indexed: 06/01/2023]
Abstract
The main role of imaging is to provide a description of the appearance, size, and location of adnexal lesions and associated abnormalities. In some circumstances, the aggressive potential of an adnexal lesion may be suggested on the basis of the imaging findings, the age of the patient, and the clinical data.
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Affiliation(s)
- Pierre Loubeyre
- Department of Imaging, Geneva University Hospitals, Geneva, Switzerland
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18
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Abstract
Routine ultrasonographic evaluation of the genital organs of a 3-year-old terrier bitch revealed a mass at the level of the left ovary. The mass was located next to the caudal pole of the left kidney and ventrocaudal to the left ovary. Ultrasonographically, the uterus was not enlarged and had no luminal contents. Exploratory laparotomy revealed a mass attached to the left ovarian bursa with a small and thin pedicle. The mass had smooth margins, was whitish in color, and was lobulated on cut surface. The histopathological diagnosis of the mass was leiomyoma associated with the mesosalpinx.
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Affiliation(s)
- Kemal Eker
- Department of Obstetrics and Gynecology, Faculty of Veterinary Medicine, Ankara University, 06110, Diskapi, Ankara, Turkey
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19
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Abstract
Leiomyoma of the fallopian tube is extremely rare. Most cases are asymptomatic and found incidentally at autopsy or unrelated operation. These leiomyomas tend to be singular, small, and unilateral, with a resultant rare preoperative diagnosis. They are often managed with laparotomy, as seen in the literature review. Therefore, preoperative imaging is never reported. We describe a case of leiomyoma of the fallopian tube, which was suspected before operation and treated by laparoscopic approach. Transvaginal ultrasound clearly showed a hypoechoic solid mass separate from the left ovary and uterus in a 44-year-old woman. Color Doppler ultrasound detected low impedance flow in this mass. Diagnostic laparoscopy and the follow-up laparoscopic salpingoectomy revealed a primary leiomyoma of the fallopian tube. We conclude that powerful ultrasound could be helpful in diagnosing rare gynecologic disorders but laparoscopy can be used for definite diagnosis and management of such disorders.
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Affiliation(s)
- Chin-Chun Yang
- Department of Obstetrics and Gynecology, Cardinal Tien Hospital-Hsintien, Fu Jen Catholic University, Taipei, Taiwan, ROC
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20
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Córdoba O, Gil-Moreno A, de la Torre J, Martínez-Palones JM, Díaz B, Xercavins J. Extraperitoneal laparoscopic para-aortic lymphadenectomy for lymph node recurrence of fallopian tube carcinoma. Int J Gynecol Cancer 2006; 16:991-3. [PMID: 16803474 DOI: 10.1111/j.1525-1438.2006.00595.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The endoscopic retroperitoneal approach is a minimally invasive method for surgical staging of cervical cancer. A 57-year-old woman had an intraoperative diagnosis of carcinoma of the left fallopian tube and undergone a retroperitoneal pelvic and para-aortic lymphadenectomy with no peritonization during surgical staging. Small suspicious nodes in the serous membrane of the sigmoid colon and peritoneal washings were positive for malignancy. A total of 12 nodes were obtained, all of which were negative. She received six cycles of paclitaxel and platinum-based chemotherapy and showed a complete clinical response. Thirty-two months after surgery, the abdominal computed tomography scan showed a left para-aortic lymph node, 19 mm in diameter, which was successfully removed through an extraperitoneal laparoscopic approach. The extraperitoneal laparoscopic approach of the para-aortic region is a feasible procedure after previous transperitoneal lymphadenectomy and chemotherapy.
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Affiliation(s)
- O Córdoba
- Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-infantil Vall d'Hebron, Autonomous University of Barcelona, Passeig Vall d'Hebron 119-129, E-08035 Barcelona, Spain
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21
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Krasner CN, Roche M, Horowitz NS, Supko JG, Lee SI, Oliva E. Case records of the Massachusetts General Hospital. Case 11-2006. A 54-year-old woman with a mass in the pelvis. N Engl J Med 2006; 354:1615-25. [PMID: 16611953 DOI: 10.1056/nejmcpc069002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Carolyn N Krasner
- Gillette Center for Women's Cancers, Massachusetts General Hospital, USA
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22
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Abstract
Fallopian tube carcinoma is the rarest of all female genital tract malignancies. It usually occurs in postmenopausal women and is associated with infertility. We present the first reported case of it occurring as a primary tumor in a young primigravida. It presented as a large, rapidly growing adnexal mass at 9 weeks of gestation which was removed and found to be a papillary serous carcinoma of the fallopian tube. The patient continued the pregnancy to term and delivered a live healthy infant by ventouse. A staging laparotomy in the postnatal period showed no spread of tumor, and in view of her age and desire for further pregnancies, her uterus and other ovary and tube were conserved. She remains tumor free 2 years following detection. We discuss the incidence, progress, management, and survival rates of this rare gynecological malignancy.
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Affiliation(s)
- S Batra
- Wythen shawe Hospital, Manchester, United Kingdom
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23
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Wuntkal R, Maheshwari A, Tongaonkar H, Gupta S. Bilateral fallopian tube carcinoma presenting as primary infertility. Eur J Obstet Gynecol Reprod Biol 2005; 122:244-5. [PMID: 16219526 DOI: 10.1016/j.ejogrb.2005.02.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2004] [Revised: 10/25/2004] [Accepted: 02/19/2005] [Indexed: 11/19/2022]
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24
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Abstract
Fallopian tube carcinoma is the least common of gynecological malignancies. 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. Transvaginal sonography revealed a cystic lesion of the fallopian tube with papillary projections, distinct from the ovary and uterus. Doppler examination showed low vascular impedance (resistance index 0.50, pulsatility index 0.80). The suspicion of tubal malignancy was confirmed at surgery.
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Affiliation(s)
- Ma-Lee Ko
- Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan
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25
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Huang WC, Yang SH, Yang JM. Ultrasonographic manifestations of fallopian tube carcinoma in the fimbriated end. J Ultrasound Med 2005; 24:1157-60; quiz 1161-2. [PMID: 16040833 DOI: 10.7863/jum.2005.24.8.1157] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Affiliation(s)
- Wen-Chen Huang
- Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan
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26
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Ingec M, Erdogan F, Kumtepe Y, Isaoglu U, Gundogdu C, Kadanali S. Management of bilateral fallopian tube carcinoma coexistent with tuberculous salpingitis. J Obstet Gynaecol Res 2005; 31:65-7. [PMID: 15669995 DOI: 10.1111/j.1447-0756.2005.00242.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Primary carcinoma of the fallopian tube is a rare gynecologic malignancy. Chronic tubal inflammation is associated with primary carcinoma of the fallopian tube. There are only a few reports on primary carcinoma of the fallopian tube coexisting with tuberculous salpingitis. We are reporting a patient with both the primary carcinoma of the fallopian tube and tuberculous salpingitis, which were detected in bilateral fallopian tubes. The histologic type was serous adenocarcinoma. The patient was treated with total abdominal hysterectomy, bilateral salpingo-oophorectomy, infracolic omentectomy, and bilateral pelvic lymphadenectomy followed by chemotherapy consisting of paclitaxel and cisplatin. She has been alive without evidence of disease for 18 months.
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MESH Headings
- Combined Modality Therapy
- Cystadenocarcinoma, Serous/complications
- Cystadenocarcinoma, Serous/diagnosis
- Cystadenocarcinoma, Serous/diagnostic imaging
- Cystadenocarcinoma, Serous/drug therapy
- Cystadenocarcinoma, Serous/surgery
- Diagnosis, Differential
- Fallopian Tube Neoplasms/complications
- Fallopian Tube Neoplasms/diagnosis
- Fallopian Tube Neoplasms/diagnostic imaging
- Fallopian Tube Neoplasms/drug therapy
- Fallopian Tube Neoplasms/surgery
- Female
- Humans
- Middle Aged
- Salpingitis/complications
- Salpingitis/diagnosis
- Salpingitis/diagnostic imaging
- Salpingitis/drug therapy
- Salpingitis/surgery
- Tomography, X-Ray Computed
- Tuberculosis, Female Genital/complications
- Tuberculosis, Female Genital/diagnosis
- Tuberculosis, Female Genital/diagnostic imaging
- Tuberculosis, Female Genital/drug therapy
- Tuberculosis, Female Genital/surgery
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Affiliation(s)
- Metin Ingec
- Department of Obstetrics and Gynecology, Ataturk University Faculty of Medicine, Erzurum, Turkey.
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27
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Gojnic M, Pervulov M, Petkovic S, Barisic G, Stojanovic I, Mostic T, Jeremic K. The significance of Doppler flow and anamnesis in the diagnosis of fallopian tube cancer. EUR J GYNAECOL ONCOL 2005; 26:309-10. [PMID: 15991534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
By following Doppler flow of the small pelvis with laboratory parameters and anamnesis data, we obtained more precise diagnostic possibilities for timely discovering of malignant processes in adnexal region and fallopian tube. By following patients who had come for routine check ups, prompted by a positive family history for malignant processes, resistant indexes of blood vessels in the adnexal region and vascularisation pattern were determined. Out of 78 women observed in the postmenopausal period with diagnosed adnexal masses, we found two cases of fallopian tube cancer. Resistance indexes ranged between 0.20 and 0.30 during a one-month period. Hystopathological analysis pointed to fallopian tube cancer. Besides Doppler flow, only patient history of amber extract use was significant. By CA 125 marker analysis, we found an increased value but not signifiant enough. Both patients had a positive family history according to the female hereditary line.
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Affiliation(s)
- M Gojnic
- Institute of Gynecology and Obstetrics, Clinical Center of Serbia, Belgrade, Serbia and Montenegro
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28
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Abstract
The purpose of this study is to illustrate the sonographic features of primary malignant tumors of the fallopian tube and to heighten awareness of their existence. This is a retrospective review of the imaging and clinical files of 7 patients with a primary malignant tumor of the fallopian tube found in the medical records of 4500 patients with primary gynecologic malignancies seen during the last 6 years at the authors' institution. All patients had transvaginal sonography before surgery. Images were reviewed to determine common features of this rarely encountered pathology. Transvaginal sonography showed normal ovaries in 5 patients in association with a discrete solid adnexal mass in 4. The fallopian tube origin of the mass was shown directly in 2 of these 4 patients and was inferred in the other 2 on the basis of a mass in the expected location of the fallopian tube. In the 3 patients without a discrete adnexal mass, there were more extensive changes, including large, solid adnexal masses of unknown origin (n = 2) and gross peritoneal carcinomatosis (n = 1). Fallopian tube malignancies should be considered when unexplained solid masses corresponding with the expected location of the fallopian tubes are seen in association with normal ovaries. Disease dissemination may show carcinomatosis or more extensive pelvic disease.
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Affiliation(s)
- Michael Patlas
- Department of Medical Imaging, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
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29
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Baeyens K, Fennessy F, Bleday R, Glickman J, Mortele KJ. CT features of a tubal lipoma associated with an ipsilateral dermoid cyst (2004:6b). Eur Radiol 2004; 14:1720-2. [PMID: 15316745 DOI: 10.1007/s00330-004-2269-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We present a case of a tubal lipoma associated with an ipsilateral ovarian dermoid cyst. The CT features that allow differentiation from other lipomatous pelvic tumors are highlighted.
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Affiliation(s)
- Kathy Baeyens
- Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115, USA.
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30
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Abstract
Primary Fallopian tube carcinoma (FTC) is one of the rarest gynecological malignancies, accounting for 0.18% to 1.6% of all malignant neoplasms of the female reproductive tract. Preoperative diagnosis of FTC has been previously reported; however, most patients with FTC undergo laparotomy with a presumed diagnosis of ovarian carcinoma. The final diagnosis of FTC is usually established at the time of surgery or on pathological examination. To our knowledge, this is the first report in the English scientific literature in which the preoperative diagnosis of FTC was established by the presence of an adnexal mass with an incomplete septation on transvaginal sonography.
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Affiliation(s)
- N Haratz-Rubinstein
- Department of Obstetrics and Gynecology, Long Island College Hospital, Brooklyn, New York, NY 11201, USA.
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31
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Haratz-Rubinstein N, Fromberg E, Lederman S. Sonographic diagnosis of a serous tumor of low malignant potential of the fallopian tube. J Ultrasound Med 2004; 23:869-872. [PMID: 15244314 DOI: 10.7863/jum.2004.23.6.869] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Affiliation(s)
- Natan Haratz-Rubinstein
- Department of Obstetrics and Gynecology, Long Island College Hospital, 97 Amity St, Third Floor, Brooklyn, NY 11201, USA.
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32
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Todorova M, Buzalov S, Tsaneva M, Vasilev I. [Mola hydatidosa of the uterine tube]. Akush Ginekol (Sofiia) 2004; 43:49-50. [PMID: 15341259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
A case of only rare localization of hydatidiform mole in fallopian tube is described. This localization is, recent clinical as ectopic pregnancy. In the last 25 years (1974-1999) was described only 30 cases of tubal localysation of hydatidiform mole.
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33
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Varras M, Akrivis C, Bellou A, Malamou-Mitsi VD, Antoniou N, Tolis C, Salamalekis E. Primary fallopian tube adenocarcinoma: preoperative diagnosis, treatment and follow-up. EUR J GYNAECOL ONCOL 2004; 25:640-6. [PMID: 15493187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Preoperative diagnosis of fallopian tube carcinoma is difficult due to the rarity and silent course of this neoplasm. We present herein the case of a 58-year-old woman with primary fallopian tube carcinoma that was diagnosed preoperatively on the basis of a positive for adenocarcinoma Papanicolaou vaginal smear, repeated episodes of vaginal bleeding, negative endocervical and endometrial curettage, characteristic features on ultrasonography and elevated CA-125 levels. The patient was treated by total abdominal hysterectomy, bilateral salpigno-oophorectomy and omentectomy. Pathologic confirmation of primary serous papillary adenocarcinoma of the left fallopian tube was made. Peritoneal washings were positive for malignancy. FIGO stage was considered as IIIb and the patient received six courses of combined carboplatin-taxol chemotherapy. At two years from onset of therapy the patient underwent a modified radical mastectomy and lymphadenectomy because of primary carcinoma of the right breast. The patient was started on tamoxifen therapy, which she is still taking. At 60 months after initial surgery, the patient is alive and well. In conclusion, our study suggests an association between fallopian tube carcinoma and breast cancer and a good response of the patient to platinum-based chemotherapy.
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MESH Headings
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Breast Neoplasms/diagnosis
- Breast Neoplasms/drug therapy
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/diagnosis
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/surgery
- Combined Modality Therapy
- Cystadenocarcinoma, Papillary/diagnosis
- Cystadenocarcinoma, Papillary/diagnostic imaging
- Cystadenocarcinoma, Papillary/drug therapy
- Cystadenocarcinoma, Papillary/pathology
- Cystadenocarcinoma, Papillary/surgery
- Diagnosis, Differential
- Estrogen Antagonists/therapeutic use
- Fallopian Tube Neoplasms/diagnosis
- Fallopian Tube Neoplasms/diagnostic imaging
- Fallopian Tube Neoplasms/drug therapy
- Fallopian Tube Neoplasms/pathology
- Fallopian Tube Neoplasms/surgery
- Female
- Humans
- Mastectomy
- Middle Aged
- Neoplasm Staging
- Postoperative Period
- Preoperative Care
- Tamoxifen/therapeutic use
- Ultrasonography
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Affiliation(s)
- M Varras
- 3rd Department of Obstetrics and Gynaecology, University General Hospital ATTIKON, Athens, 3rd District National Health System, Athens (Greece).
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Mikami M, Tei C, Kurahashi T, Takehara K, Komiyama S, Suzuki A, Kishikawa T, Fukuiya T. Preoperative diagnosis of fallopian tube cancer by imaging. ACTA ACUST UNITED AC 2003; 28:743-7. [PMID: 14628888 DOI: 10.1007/s00261-003-0009-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Primary cancer of the fallopian tube (FTC) is among the most unusual gynecologic malignancies and rarely is diagnosed correctly before surgery. The imaging results of eight patients with FTC and four with benign tubal disease were analyzed. FTCs were small cystic or solid masses that typically were shaped like a sausage, a snail, or a gourd, regardless of clinical stage.
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Affiliation(s)
- M Mikami
- Department of Obstetrics and Gynecology, Department of Clinical Research, National Saitama Hospital, Suwa 2-1, Wako, Saitama 351-0102, Japan
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35
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Santana P, Desser TS, Teng N. Preoperative CT diagnosis of primary fallopian tube carcinoma in a patient with a history of total abdominal hysterectomy. J Comput Assist Tomogr 2003; 27:361-3. [PMID: 12794600 DOI: 10.1097/00004728-200305000-00011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Fallopian tube carcinoma is an unusual gynecologic malignancy that is rarely diagnosed preoperatively. We report a case of fallopian tube carcinoma occurring in a patient who had undergone a hysterectomy many years previously, in whom findings on computed tomography and ultrasound were highly suggestive of the diagnosis.
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Affiliation(s)
- Patricia Santana
- Department of Radiology, Stanford University School of Medicine, Stanford, CA 94305, USA
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36
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van Leeuwen BL, Pruim J, Gouw ASH, van der Zee AGJ, Slooff MJH, de Jong KP. Liver metastasis as a first sign of fallopian tube carcinoma and the role of positron emission tomography in preoperative diagnosis. Scand J Gastroenterol 2002; 37:1473-4. [PMID: 12523601 DOI: 10.1080/003655202762671396] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The search for an unknown primary tumour is often time-consuming, costly and unrewarding. Positron emission tomography might be an effective method for screening the body for malignant deposits. We present the case of a woman with a symptomatic liver tumour of unknown origin. Several investigations did not reveal a primary tumour, but PET scanning showed a hot spot in the pelvis, suggesting either a primary tumour or a metastatic deposit. During operation, a primary Fallopian tube carcinoma was detected. Histopathological examination of the resected liver tumour revealed a metastasis of the Fallopian tube carcinoma. This case report demonstrates that PET scanning can be useful in the diagnostic process in patients with unknown primary tumour, and that a symptomatic liver tumour can be the first sign of Fallopian tube carcinoma.
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Affiliation(s)
- B L van Leeuwen
- Dept. of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, PET-Center, Laboratory Medicine, Groningen University Hospital, The Netherlands
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Abstract
BACKGROUND Fallopian tube carcinoma is a rare malignancy that commonly recurs after initial surgical resection. New combined instrumentation with co-registered PET and CT is a new technique that combines functional and anatomic imaging to detect metastatic disease that may be difficult to detect with either modality alone. CASE We present two cases of suspected fallopian tube carcinoma recurrence demonstrating the unique potential of combined PET-CT using 18F-fluoro-2-deoxyglucose (FDG). These cases demonstrate the unique capability to detect and localize metastatic disease when serum CA-125, laparoscopy, and CT scan alone were unable to detect recurrence. CONCLUSION PET-CT with FDG may prove to be a sensitive and accurate method for detection of metastatic disease and may influence the clinical management of recurrent fallopian tube carcinoma.
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Affiliation(s)
- Pavni V Patel
- Johns Hopkins Medical Institutions, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Outpatient Center, Baltimore, Maryland 21287, USA
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Affiliation(s)
- Jimmy H F Yuen
- Department of Radiology, Queen Mary Hospital, Hong Kong, Hong Kong
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Abstract
Extraskeletal chondroma can occur in the hands, feet, head and neck. This tumor usually presents as a small solitary nodule. The histogenesis of the tumor is controversial, but some have suggested a metaplastic origin. Chondroma of the fallopian tube is very rare. There is only one report in English literature. The origin of this tumor can be subcoelomic mesenchyme of the tubal serosa or mesenchyme of the myosalpinx. We describe a case of chondroma arising from the serosal surface of the fallopian tube with a review of literature. A 30-yr-old woman visited hospital due to left adnexal mass. On operating finding, 2 x 3 cm sized nodular mass was noted on the left tubal serosal area. The excised mass showed multilobulated appearance covered with thin fibrous membrane. The cut surface was solid, grayish yellow, and myxoid with a focal gelatinous area. The microscopic finding showed islands and elongated lobules of mature benign cartilage without cytologic atypia.
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Affiliation(s)
- Jee-Young Han
- Department of Pathology, College of Medicine, Inha University, Inchon, Korea.
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Makhija S, Howden N, Edwards R, Kelley J, Townsend DW, Meltzer CC. Positron emission tomography/computed tomography imaging for the detection of recurrent ovarian and fallopian tube carcinoma: a retrospective review. Gynecol Oncol 2002; 85:53-8. [PMID: 11925120 DOI: 10.1006/gyno.2002.6606] [Citation(s) in RCA: 101] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE Imaging modalities to evaluate ovarian/fallopian tube cancer patients for recurrence are limited. Positron emission tomography (PET), computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound lack the sensitivity to consistently detect recurrence or measurable disease in these patients. A new technique combines PET and CT (PET/CT) images to identify increased metabolic activity and to locate that signal with improved anatomic specificity. The objective of this study is to compare PET/CT, CT, and histologic findings in patients with recurrent ovarian/fallopian tube cancers. METHODS Retrospective chart review of eight patients with primary ovarian (n = 6) or fallopian tube (n = 2) cancer was performed. All eight patients underwent initial cytoreductive surgery. Five patients initially received chemotherapy, one received radioactive phosphorus ((32)P), one received tamoxifen, and one received no therapy. Seven of eight patients had a suspected recurrence based on clinical examination, elevated CA-125 level, and/or abnormal CT findings; one patient requested a PET/CT. Histologic findings from surgery were correlated with PET/CT and CT findings. RESULTS All eight patients had positive histology, and of these, seven patients had a negative CT and five patients had lesions that were correctly identified by PET/CT. CONCLUSIONS Five of the eight (62%) patients had recurrent disease based on correlative histology with a positive PET/CT and a negative CT. These preliminary findings suggest that combined PET/CT may be an effective means of identifying patients with recurrent ovarian/fallopian tube cancer. Such patients could potentially proceed to salvage treatment and avoid the morbidity and expense of surgical assessment. Pilot studies comparing CT, PET, PET/CT, and histologic findings are underway.
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Affiliation(s)
- S Makhija
- Division of Gynecologic Oncology, University of Alabama at Birmingham, 35243, USA
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Abstract
OBJECTIVE To study a spectrum of systems (two-dimensional transvaginal, transvaginal color Doppler, three-dimensional, three-dimensional power Doppler, and contrast-enhanced three-dimensional power Doppler sonography) for preoperative evaluation of pelvic tumors. METHODS Two hundred ninety-two patients were evaluated by the 5 complementary methods in preoperative sonographic assessments. We examined adnexal and endometrial morphology, thickness, and volume by two- and three-dimensional sonography and analyzed blood flow by transvaginal color, pulsed Doppler, and three-dimensional power Doppler sonography in all examined patients. In 89 patients with complex adnexal lesions of uncertain malignancy, contrast-enhanced three-dimensional power Doppler sonography was performed. RESULTS Morphologic assessment by three-dimensional sonography yielded additional information in 58% of cases compared with two-dimensional sonography. Furthermore, this modality was superior to two-dimensional sonography in accurate depiction and diagnosis of 2 cases of fallopian tube carcinoma. Combined morphology and vascular indexing reached sensitivity of 97% and specificity of 99%. Endometrial volume in patients with malignant disease was significantly different (28.2 +/- 0.02 cm3) from that in those who had hyperplasia (7.81 +/- 0.03 cm3), polyps (3.5 +/- 0.02 cm3), or normal endometria (0.8 +/- 0.02 cm3). With combined morphologic and three-dimensional power Doppler examination of endometrial lesions, sensitivity and specificity reached 89% and 97%, respectively. CONCLUSIONS Combined morphologic and vascular imaging improves preoperative assessment of gynecologic tumors.
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Affiliation(s)
- A Kurjak
- Department of Obstetrics and Gynecology, Medical School, University of Zagreb, Sveti Duh Hospital, Croatia
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Abstract
We report a mature solid teratoma arising in the fallopian tube. The mass was noted on CT scan prior to surgery for a mature cystic teratoma of the contra-lateral ovary. Neoplasms of the fallopian tube are very uncommon. Moreover, the incidence of a mature solid teratoma of the fallopian tube is extremely low.
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Affiliation(s)
- T Yoshioka
- Department of Obstetrics and Gynecology, Akita University School of Medicine, 1-1-1 Hondo, Akita, Japan.
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Kurjak A, Kupesic S, Jacobs I. Preoperative diagnosis of the primary fallopian tube carcinoma by three-dimensional static and power Doppler sonography. Ultrasound Obstet Gynecol 2000; 15:246-251. [PMID: 10846782 DOI: 10.1046/j.1469-0705.2000.00080.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
OBJECTIVE To investigate whether three-dimensional static and power Doppler ultrasound improves the diagnosis of primary Fallopian tube carcinoma. METHODS During a 2-year period five cases of primary Fallopian tube carcinoma were selected from a cohort of 520 patients with a previous scan suggestive of an adnexal tumor. RESULTS Tubal malignancy occurred in patients between 49 and 64 years, with presenting symptoms such as pain, vaginal bleeding and leukorrhea. CA 125 was elevated in three cases of tubal carcinoma with stages II and III, while in two patients with stage I, CA 125 was within the normal limits. Two-dimensional ultrasound demonstrated sausage shaped cystic masses with papillary projections in two patients and a complex adnexal mass in one patient. Three-dimensional ultrasound revealed sausage shaped cystic and/or complex masses with papillary projections in all five cases of tubal malignancy. In one patient preoperative 3-D ultrasound correctly predicted bilateral tumors, while 2-D transvaginal sonography found only unilateral changes. Additional 3-D power Doppler examination depicted vascular geometry typical for malignant tumor vessels such as arteriovenous shunts, microaneurysms, tumoral lakes, blind ends and dichotomous branching in each of the cases with Fallopian tube carcinoma. CONCLUSIONS Three-dimensional ultrasound allows precise depiction of tubal wall irregularities such as papillary protrusions and pseudosepta. Improved understanding of anatomical relationships may aid in distinguishing ovarian from tubal pathology. Multiple sections of the tubal sausage like structures enable determination of local tumor spread and capsule infiltration. Study of the vascular architecture in cases of Fallopian tube malignancy is further enhanced using 3-D power Doppler imaging.
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Affiliation(s)
- A Kurjak
- Department of Obstetrics and Gynecology, Medical School, University of Zagreb, Sveti Duh Hospital, Croatia
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Neel SP, Maheshwari A, Shylasree TS, Tongaonkar HB, Kulkarni JN. Primary carcinoma of fallopian tube--a case study. Indian J Cancer 1999; 36:201-4. [PMID: 10921228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Primary carcinoma of fallopian tube is a rare entity. We report an interesting case of primary carcinoma of fallopian tube with contralateral lymph node involvement. The clinicopathological findings and its management is presented.
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Affiliation(s)
- S P Neel
- Department of Surgical Oncology, Tata Memorial Hospital, Maharashtra, India
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Sawicki W. [Evaluation of modern ultrasonography in diagnosis of uterine and adnexal neoplasms]. Ginekol Pol 1999; 70:218-20. [PMID: 10582410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Affiliation(s)
- W Sawicki
- I Kliniki Połoznictwa i Ginekologii II Wydziału Lekarskiego A.M w Warszawie
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46
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Wansaicheong GK, Ong CL. Intramural tubal polyps--a villain in the shadows? Singapore Med J 1998; 39:97-100. [PMID: 9632965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Intramural tubal polyps are commonly described in association with subfertility. However, there is unfamiliarity among clinicians about the investigations available for making a diagnosis of this condition. The objective of this paper was to highlight the suitable investigations for diagnosis and thus increase awareness of this condition and its relationship with subfertility. METHOD A retrospective review of 14 patients with intramural tubal polyps was done for the period from January to December 1996. An attempt was made to correlate the radiographic findings on hysterosalpingography with transvaginal ultrasound examinations and hydrochromotubation performed under laparoscopic observation. The fertility history of these patients was also examined. RESULTS The review demonstrated a prevalence of 3.8% of intramural tubal polyps in a selected population of predominantly subfertile women. Only hysterosalpingography was useful in making the diagnosis in-vivo. Fifty percent of the patients did not have any other obvious pathology to explain their subfertility. CONCLUSION We conclude that meticulous hysterosalpingography is useful as a diagnostic investigation and that consistent reporting is needed for good follow-up.
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Affiliation(s)
- G K Wansaicheong
- Department of Diagnostic Imaging, KK Women's and Children's Hospital, Singapore
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Abstract
INTRODUCTION Transvaginal color and pulsed Doppler can detect areas of neovascularization within the tubal carcinoma and can distinguish it from other benign adnexal pathology. SUBJECTS AND METHODS. During a 7-year period eight cases of Fallopian tube carcinoma were detected using transvaginal color and pulsed Doppler. RESULTS Transvaginal sonography revealed complex, sausage-shaped, and/or cystic structures in the adnexal region. Additional color Doppler examination depicted low vascular impedance (RI ranged from 0.29 to 0.40). Histopathology reported different types of Fallopian tube carcinoma. CONCLUSION Transvaginal color Doppler may aid in diagnosis of Fallopian tube malignancy more reliably than using other costly diagnostic procedures.
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MESH Headings
- Adenocarcinoma/blood supply
- Adenocarcinoma/diagnostic imaging
- Adenocarcinoma/pathology
- Adenocarcinoma, Clear Cell/blood supply
- Adenocarcinoma, Clear Cell/diagnostic imaging
- Adenocarcinoma, Clear Cell/pathology
- Adnexa Uteri/blood supply
- Adnexa Uteri/pathology
- Carcinoma, Papillary/blood supply
- Carcinoma, Papillary/diagnostic imaging
- Carcinoma, Papillary/pathology
- Cystadenocarcinoma/blood supply
- Cystadenocarcinoma/diagnostic imaging
- Cystadenocarcinoma/pathology
- Fallopian Tube Neoplasms/blood supply
- Fallopian Tube Neoplasms/diagnostic imaging
- Fallopian Tube Neoplasms/pathology
- Female
- Humans
- Middle Aged
- Neovascularization, Pathologic
- Retrospective Studies
- Ultrasonography, Doppler, Color/methods
- Ultrasonography, Doppler, Color/standards
- Ultrasonography, Doppler, Pulsed/methods
- Ultrasonography, Doppler, Pulsed/standards
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Affiliation(s)
- A Kurjak
- Sveti Duh Hospital, Medical School University of Zagreb, Zagreb, 10000, Croatia
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Affiliation(s)
- C L Ong
- Department of Diagnostic Imaging, KK Women's and Children's Hospital, Singapore, Singapore
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Abstract
OBJECTIVE The purposes of this study were to investigate the imaging findings in patients with primary fallopian tube neoplasms and to determine whether specific imaging features favor the preoperative diagnosis of fallopian tube tumors (FTT). MATERIALS AND METHODS Computerized search of medical records from 1984 to 1994 identified 20 patients with a discharge diagnosis of primary fallopian tube carcinoma. Medical records, imaging studies, and pathology findings were reviewed. Eleven patients had available preoperative imaging. RESULTS Seventeen of 20 patients with primary FTT had unilateral disease. Of these 17, preoperative imaging was available in nine, showing four solid adnexal masses, four complex cystic adnexal masses, and one normal adnexa. The preoperative imaging of these nine patients included six sonographic and five CT studies. Three patients with primary FTT had bilateral tumors, and preoperative imaging was available for two patients: Two sonographic studies and one CT study showed one complex cystic adnexal mass and three normal adnexa. CONCLUSION Primary FTT commonly presents as an adnexal mass on preoperative imaging and mimics other pelvic malignancies, especially ovarian carcinoma. Making a specific preoperative diagnosis is difficult; however, because primary FTT is unlikely to be confused with a benign process, delay in diagnosis is rare.
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Affiliation(s)
- P J Slanetz
- Department of Radiology, Massachusetts General Hospital, Boston 02114, USA
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Figliolini M, Grassi A, Eleuteri Serpieri D, Pace S, Figliolini C, Agneni M. [Diagnostic and therapeutic problems in tubal adenocarcinoma. Report of a case]. Minerva Ginecol 1997; 49:499-507. [PMID: 9489348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Primary adenocarcinoma of the Fallopian tube is one of the most rare tumours: its incidence varies from 0.5% to 1.1% of all gynecological neoplasias. In 1988 a total of 1,200 cases had been reported, the majority grouped in small series and/or individual case reports. The first case was reported by Renauld in 1847. The preoperative diagnosis has increased over the past forty years from 0.26% to 6.38%, and is still extremely low. The diagnosis of primary adenocarcinoma of the uterine tube is basically achieved by exclusion, and in fact the metastasization of the tubes by adjacent gynecological organs must be excluded. The trio of abdominal pain, leukorrhea, metrorrhagia is regarded by many authors as being pathognomonic of tubal adenocarcinoma. In about half of patients the interval between the onset of symptoms and histological diagnosis is 2-3 months, and in 30% less than one month. The authors report their experience of a case in a 62-year-old patient with typical symptoms of primary tubal adenocarcinoma.
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Affiliation(s)
- M Figliolini
- II Istituto di Clinica Ostetrica e Ginecologica, Università degli Studi di Roma La Sapienza, Roma
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