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This is a case of malignant mixed Müllerian tumor arising primarily from the fallopian tube. The tumor was distant metastasis to the omentum and the serosa of the sigmoid colon. Literatures published in the last two decades are reviewed and discussed.
A 17-year-old female with severe pain of the midabdomen was found to have a retroperitoneal cystic tumor, an ectopic ovary and a fallopian tube without fimbriated end. An attempt is made to determine whether these early embryonic malformations could be traced to a common origin. This is possible provided that the tumor is regarded as a mesonephroma. A histological study of the normal development of the Mullerian duct was performed utilizing human embryonic series. Previous development theories and more recent investigations are discussed. Malformations of the tube described in the literature and possible etiologies are summarized.
A case of tubal carcinoma is presented, which was initially misdiagnosed as an endometrial carcinoma. This was due to a superficial metastasis yielding material during the curettage which simulated an anaplastic adenocarcinoma. The difficulty of correctly diagnosing tubal carcinoma preoperatively has been discussed.
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A case of early bilateral serous papillary adenocarcinoma of the ovaries in an asymptomatic 58-year-old woman was diagnosed by the discovery of psammoma bodies in routine cervicovaginal and endometrial smears. Multiple small foci of carcinoma in-situ involving both fallopian tubes were also present. The significance of psammoma bodies in the cervicovaginal smear is discussed and the literature on the subject briefly reviewed.
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Although a common site of metastases, primary fallopian tube carcinoma comprises only 0.3% of all gynaecological malignancies. Presenting symptoms are variable and non-specific, with preoperative diagnosis rarely entertained. The FIGO system assigns nearly two-thirds of patients to stage I or II and is based on surgical staging criteria similar to those for ovarian cancer. Likewise, management is based on that for ovarian cancer-radical debulking followed by platinum-based combination chemotherapy. Five-year survival for patients with disease confined to the tube at diagnosis (stage I) is only about 60% and only 10% of patients with advanced disease will be cured.
Port-site metastases following laparoscopic surgery for cancer constitute an emerging problem. We report a case of cutaneous metastasis at a port site following laparoscopically assisted vaginal hysterectomy and salpingo-oophorectomy for unsuspected adenocarcinoma of the fallopian tube. This complication occurred 7 months postoperatively and was treated with resection. A single site was involved. Possible etiologies are implantation from "contaminated" instruments or dissemination of tumor cells by the positive-pressure pneumoperitoneum. Preventive measures include precise and clean surgical technique, the use of a nonporous bag, postoperative trocar-site excision or irradiation, and conversion to laparotomy either intra- or postoperatively.
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This case report deals with a primary endometrioid carcinoma within a Morgagni hydatid in a 43 years old woman. The woman died 27 month after first operation. Morgagni hydatids should be exstirpated in any case with histologic examination for they may become malignant.
The morphology of the pars intramuralis of the fallopian tube has been histological examined in 500 uteri which were exstirpated in the Department of Gynaecology and Obstetrics of the University of Kiel in the years of 1972 to 1973. It was found that the interstitial pars of the endometrium changes regularly during the menstrual cycle. In the same way the endometrium in the interstitial part of the tubal canal suffers from an atrophy if patients were treated with gestagens. The adenomatous hyperplasie or the polypes of the endometrium which are often found near the utero-tubal junction are to be considered as the matrix of the carcinoma of the endometrium; continuous changes between the adenomatous hyperplasie and the carcinoma of the endometrium can be observed. The frequency of precancers near the utero-tubal junction underlines the demand for an accurate curettage in this region of the cavum uteri. The histological examination of the region of the utero-tubal junction after the extirpation of the uterus is absolutely necessary and has to be generally to be asked for.
An observation of heterologous mesodermal tumor of the fallopian tube in a woman of 53 is described. The tumor had the structure of adenoacanthocarcinosarcoma with inclusions of atypical cartilage. The patient died 6 months after the operation from generalized process. The rare localization of this tumor is noted.
Primary carcinoma of the fallopian tube is the least common of the malignant tumors of the female genital tract. Ten cases of primary fallopian tube carcinoma treated at the Women's Department of the University Hospital Mannheim between 1965 and 1983 are described. Four patients survived five years, of whom three had a stage I tumor. The most important factor affecting survival appeared to be the extent of the tumor at the time of diagnosis.
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