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PubMed1989

Incidence of malignant fallopian tube tumors.

Incidence rates were examined for epithelial malignant fallopian tube neoplasms diagnosed between 1973 and 1984 and reported to nine population-based cancer registries in the United States. The average annual incidence was 3.6 per million women per year and there was no evidence of a change in the rate during the study period. Age-specific incidence followed a pattern similar to that observed for ovarian and endometrial neoplasms, rising rapidly during the reproductive years and flattening out thereafter. The incidence rate varied only slightly by race, with whites having a higher rate than blacks. Considerable variation in incidence was observed among the registries. While this could have been due to true regional differences in incidence, we cannot rule out the possibility that misclassification of fallopian tube tumors as ovarian tumors was responsible. Further investigations into the etiology of fallopian tube neoplasms should focus on the role of reproductive factors that have previously been reported as risk factors for ovarian and endometrial neoplasms.

Adult↗

PubMed1999

Post-hysterectomy fallopian tube carcinoma presenting with a positive Papanicolaou smear.

BACKGROUND: Fallopian tube carcinoma is a rare gynecologic malignancy. The majority of women present with vaginal bleeding and have advanced disease. CASE: A 76-year-old woman presented 34 years after vaginal hysterectomy with a routine Papanicolaou smear showing adenocarcinoma. Rectovaginal examination was remarkable for thickening at the vaginal apex. Colposcopy found a pinpoint opening in this area, and a cytobrush passed through the opening confirmed adenocarcinoma. Pelvic ultrasound, computed tomography scan, and CA 125 were normal. At laparotomy, the right fallopian tube and ovary were adherent to the vaginal apex. A grade II papillary serous adenocarcinoma confined to the tube was discovered. CONCLUSION: According to a MEDLINE search, this is the third report detailing a unique presentation of fallopian tube carcinoma after hysterectomy and possibly the first detected with positive Papanicolaou cytology.

Adenocarcinoma↗

PubMed1993

Primary carcinoma of the fallopian tube.

BACKGROUND: Because of the rarity of fallopian tube cancer, 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.

Adult↗

PubMed1988

Prognostic features of carcinoma of the fallopian tube.

One hundred fifteen women with carcinoma of the fallopian tube were examined in this retrospective review. A third of the patients were nulliparous and 37% had evidence of old pelvic inflammatory disease. The most common symptoms were bleeding, pain, and/or vaginal discharge. Prognostic factors that predicted death from tumor were the presence of extratubal disease at initial surgery and the bulk of residual tumor left after the initial surgery. With disease limited to the fallopian tube, the depth of invasion of the tubal wall was correlated with the risk of treatment failure. Among patients with disease limited to their fallopian tubes, there was no statistically significant improvement in survival with the addition of either pelvic irradiation or single-agent chemotherapy. Among women with extrapelvic disease, survival improved significantly with the use of cis-platinum-containing multiagent chemotherapy.

Adult↗

PubMed1989

Primary adenocarcinoma of the fallopian tube--a case report.

Adenocarcinoma of the fallopian tube is a rare clinical entity. The incidence of primary tubal carcinoma has been reported as varying from 0.1 to 1.0 percent of all gynaecological malignancies. In Malaysia the incidence is unknown. A case of primary adenocarcinoma of the fallopian tube is reported.

Adenocarcinoma↗

PubMedDate not supplied

Fallopian tube torsion: laparoscopic evaluation and treatment of a rare gynecological entity.

BACKGROUND: Fallopian tube torsion is a cause for acute low abdominal pain that is difficult to diagnose. The purpose of this article is to review the available data on and to update clinicians regarding its diagnosis and treatment in the era of laparoscopic surgery. METHODS: We searched in MEDLINE and EMBASE and reviewed the lists of references. The keywords used were "laparoscopy," "fallopian tube," and "torsion." RESULTS AND CONCLUSION: Fallopian tube torsion is an uncommon cause for acute low abdominal pain in women. Because it has no pathognomonic clinical symptoms or findings on imaging or laboratory studies, a history of current or past pelvic pathologic conditions or surgery, as well as pregnancy, should draw the attention of the attending physician to its occurrence. Early laparoscopy is the reference standard in the diagnosis and treatment.

Blood Flow Velocity↗

PubMed1977

The role of prostaglandins in the spontaneous motility of the fallopian tube.

Spontaneous isometric contractions of the human fallopian tube were measured in vitro. The tubes were obtained during the follicular phase of the menstrual cycle in 16 experiments and during the luteal phase in 23 experiments. The area under the curve and the frequency of spontaneous isometric contractions, together with the amount of prostaglandins E and F produced by the tube, were measured. Using each tissue as its own control, the effects of adding indomethacin or papeverine to the tissue both were assessed. Indomethacin, a prostaglandin synthetase inhibitor, significantly reduced the prostaglandin output without affecting the tubal motility. By contrast, papaverine, which is a smooth muscle relaxant but not an inhibitor of prostaglandin synthesis, significantly reduced both motility and prostaglandin output. It is concluded that prostaglandins do not have a direct role in the regulation of the spontaneous motility of the human fallopian tube.

Fallopian Tubes↗

PubMed1985

Absorbable external rings for anastomosis of the fallopian tubes: a feasibility study.

A novel approach to tubotubal anastomosis with external, absorbable, ring-shaped devices was evaluated. Fallopian tubes of female Sprague-Dawley rats were transected and coagulated and either left divided or anastomosed with microsurgical technique, with or without external rings. Postoperative patency and pregnancy rates were used to evaluate the procedures. Transected and coagulated fallopian tubes remained occluded at the time of repeated surgery, and no implantations were observed in the corresponding uterine horns. Of ten fallopian tubes anastomosed without the ring, five were patent and five were partially blocked. All ten fallopian tubes anastomosed with the external rings were fully open. Implantation sites were observed in four of ten uterine horns corresponding to fallopian tubes anastomosed without the ring and in eight of ten horns anastomosed with the external ring. The difference was statistically significant, P = to 0.03. All external rings were completely absorbed 7 weeks after anastomosis. The new technique was simpler to perform and was less time-consuming. We conclude that tubotubal anastomosis with external rings may offer advantages over the conventional technique.

Animals↗

PubMed2000

Complete response to topotecan of recurrent fallopian tube carcinoma.

OBJECTIVE: To describe the first complete response of recurrent Fallopian tube carcinoma to topotecan. METHODS: A patient with recurrent Fallopian tube carcinoma previously treated with paclitaxel (Taxol) and carboplatin is described. RESULTS: This patient demonstrated a complete clinical response to topotecan. Radiographic and CA-125 measurements were used to determine response. Response was noted after four cycles and a complete response demonstrated after six treatments. CONCLUSION: Topotecan appears active in recurrent Fallopian tube carcinoma.

Aged↗

PubMed1998

Primary transitional cell carcinoma of the fallopian tube: a case report and review of the literature.

Primary carcinoma of the fallopian tube is extremely rare and the preoperative diagnosis is often misdiagnosed as an ovarian carcinoma. We report a patient with primary carcinoma of the fallopian tube, strongly suspected preoperatively on the basis of characteristic clinical symptoms, elevated CA125 levels, and transvaginal sonography, computed tomography, and magnetic resonance imaging findings. The histology of fallopian tube carcinoma was demonstrated as transitional cell carcinoma. Extensive review of the literature showed that our case seemed to be the 14th case of primary transitional cell carcinoma of the fallopian tube.

Carcinoma, Transitional Cell↗

PubMed1976

Ectopic pancreas in the fallopian tube. Report of a first case.

A case of ectopic pancreas in the fallopian tube is reported. This small, polypoid, benign tumor was in a fallopian tube contralateral to a ruptured tubal pregnancy. The patient had a tubal ligation performed six years previously. To the best of our knowledge this is the first reported case of isolated ectopic pancreas in a fallopian tube. No explanation is offered for the pathogenesis of this lesion.

Adult↗

PubMed1990

Histopathology of fallopian tubes with recurrent tubal pregnancy.

Fifteen fallopian tubes in which a previous ipsilateral eccyesis was managed by conservative surgical techniques were examined. The condition of the tube relative to the previous surgical management and the resolution of the previous implantation sites were correlated with the recurrent tubal pregnancy. All previous incisions were identified and all were well-healed, except for one fistula. Residual histologic evidence was present in only five of 16 previous implantation sites. The recurrent eccyeses were related to previous surgical management in only three women, two after anastomosis and one because of inadvertent obstruction of the tube. The cases of tubal obstruction and tuboperitoneal fistula formation were thought to reflect a lack of understanding of the pathologic changes associated with tubal pregnancy during conservative surgery. The previous tubal incision sites were all remarkably well-healed regardless of whether they were primarily closed or left open, and independent of location. Infundibular or fimbrial "milk-outs" were without histologic evidence of damage. The underlying tubal disease (chronic salpingitis, follicular salpingitis, or salpingitis isthmica nodosa) seems to be the major factor identified that is associated with, and probably the cause for, the recurrent tubal gestation.

Adult↗

PubMed1999

Gonococcal infection of human fallopian tube mucosa in organ culture: relationship of mucosal tissue TNF-alpha concentration to sloughing of ciliated cells.

BACKGROUND AND OBJECTIVES: An experimental model consisting of gonococcal infection of human fallopian tube mucosa in organ culture has proven useful in studying the molecular pathogenesis of acute gonococcal salpingitis and postsalpingitis sequelae. Gonococcal infection of human fallopian tube mucosa in organ culture results in the sloughing of ciliated epithelial cells from the mucosa. This damage to the mucosa can be quantified on fallopian tube pieces by an assay of the percent of the periphery that has ciliary activity (PPCA) remaining at specific time points after infection. Although assay of the PPCA has been quite valuable, it is labor-intensive, somewhat subjective, and requires that the observers have training and experience. A more practical assay for genital mucosal damage is desirable for further investigations that employ the fallopian tube experimental model. Gonococcal infection of fallopian tube mucosa in organ culture also results in the production of easily quantified tumor necrosis factor-alpha (TNF-alpha) by the mucosa. Furthermore, treatment of the organ cultures with recombinant human TNF-alpha (rHuTNFalpha) alone also causes sloughing of ciliated cells from the mucosa. These findings strongly suggest that TNF-alpha is a mediator of the mucosal damage that attends gonococcal infection. GOALS OF THE STUDY: To determine: (1) whether the PPCA values and the TNF-alpha concentrations in fallopian tube mucosal tissues correlate closely enough to allow prediction of the PPCA from a measurement of the mucosal tissue TNF-alpha concentration; and (2) whether the correlation of the TNF-alpha mucosal tissue concentration with the sloughing of ciliated cells (measured by the PPCA) supports the hypothesis that induction of TNF-alpha by gonococcal infection, with resultant sloughing of ciliated cells, is likely to be a major pathogenic mechanism of gonococcal salpingitis and might mediate postsalpingitis infertility and ectopic pregnancy. STUDY DESIGN: A metaanalysis was performed on studies from three research groups (two laboratories in the United States and one in the United Kingdom, using identical techniques for quantifying the PPCA, TNF-alpha, or both. RESULTS: There was a close and statistically significant correlation between the TNF-alpha mucosal tissue concentration and the proportion of ciliated cells lost from the mucosa as measured by the PPCA (r = 0.95, p < 0.001). Therefore, as the mucosal tissue concentration of endogenous TNF-alpha increased, the loss of ciliated cells from the epithelium increased proportionately. CONCLUSIONS: During gonococcal infection of human fallopian tube mucosa in organ culture, the mucosal tissue concentration of TNF-alpha can be used to predict the PPCA, and therefore, the extent of mucosal damage. This finding should facilitate studies of the molecular pathogenesis of infectious diseases involving human genital mucosa. Further, the close correlation of mucosal TNF-alpha concentration with genital mucosal damage, evaluated by the PPCA, supports the hypothesis that induction of the proinflammatory cytokine, TNF-alpha, by gonococcal infection, with resultant inflammation and sloughing of ciliated cells, is an important pathogenic mechanism of gonococcal salpingitis and may mediate postsalpingitis infertility and ectopic pregnancy as well.

Cilia↗

PubMed2001

Unilateral ovarian agenesis and fallopian tube maldescent.

Unilateral ovarian agenesis (UOA) and fallopian descent problems are very rare congenital defects. We present an unusual case of UOA associated with fallopian-tube maldescent discovered incidentally during a laparotomy in a female infant for a persistent heterogeneous right ovarian cyst refractory to needle aspiration. A necrotic, hemorrhagic paratubal cyst was found associated with a normal right adnexa. The left ovary was absent and a rudimentary left fallopian tube was found tightly stretched over the sigmoid colon to the left retroperitoneum. This previously unreported constellation of anomalies may carry significant potential risks for bowel obstruction and later fertility.

Diagnosis, Differential↗

PubMed1977

[Clinical problems, therapy and prophylaxis of primary carcinoma of the fallopian tube (author's transl)].

31 cases of primary carcinoma of the fallopian tube from 1960 to 1976 are reported. All these patients underwent operative treatment at the 1st University Clinic of obstetrics and gynaecology of Vienna. 8 out of 23 patients survived for more than 5 years. The evident advantage of a complete operation with post operative telecobalt radiotherapy for the results of 5-years-survival is shown. The possibility and necessity of prophylaxis of carcinoma of the fallopian tube by extirpation of both fallopian tubes in any case of hysterectomy are emphasized.

Adult↗

PubMed1998

The efficacy of transcervical recanalization of obstructed postoperative fallopian tubes.

The efficacy of transcervical recanalization of obstructed postoperative Fallopian tubes was evaluated in 29 patients who were referred for recanalization. Nineteen had strictures at the site of Fallopian tube reconstruction, and five had strictures, three had fistulae, and two had fistulae and strictures at the site of reversal surgery. A 0.014-inch highly flexible guidewire was passed through the obstruction into the ampullary segment, followed by a 1. 1-2.2 Fr bougie catheter to dilate the stricture. After recanalization, the distal tube was studied by selective salpingography. The method was technically successful in 17 of 19 patients with underlying inflammatory disease and resultant postoperative strictures. The tubes remained patent in 12 patients for a period of 12-48 months; three patients conceived, all delivering healthy babies. Significant disease of the distal tubes was present in seven patients. The technique succeeded in three of five patients with postoperative strictures following reversal surgery. One patient subsequently conceived and delivered a healthy baby. The technique failed in all five patients with fistulae complicating reversal surgery. Transcervical recanalization is thus recommended in the management of patients with postoperative strictures with underlying inflammatory obstruction and strictures complicating reversal surgery.

Adult↗

PubMed1977

Studies on ciliated epithelia of the human genital tract. II. The mucociliary wave pattern of fallopian tube epithelium.

The ciliary activity of human fallopian tube epithelium was studied in vitro by using a technique which included registration of the light reflections from the mucociliary waves on the epithelial surface. In all registrations, the mucociliary waves moved toward the uterine end of the specimen. The frequencies of the reflections of the mucociliary waves ranged between 960 and 1368 cpm, with a mean of 1191 cpm (2 SD, +/- 176) and a median of 1210 cpm. Significant differences in the mucociliary wave frequencies were not observed between different parts of the fallopian tube nor between registrations performed during the follicular and luteal phases of the menstrual cycle. Scanning electron microscopy of the specimens revealed no morphologic changes of the cilia during the menstrual cycle.

Adult↗

PubMed1995

A new system for fallopian tube sperm perfusion leads to pregnancy rates twice as high as standard intrauterine insemination.

OBJECTIVE: To evaluate the relative efficacy of a new system for fallopian tube sperm perfusion in comparison with standard IUI in controlled ovarian hyperstimulation (COH) cycles. DESIGN: Prospective randomized trial. SETTING: Ovulation induction program of a tertiary outpatient care center, Hôpital Antoine Béclère, Clamart, France. PATIENTS: We studied 74 infertile women aged 20 to 38 years undergoing 100 cycles of COH from December 1993 to May 1994 only excluding cases of age > 38 years, obstructed or severely damaged fallopian tubes, E2 levels per mature follicle < 250 pg/mL (conversion factor to SI unit, 3.671) on the day of hCG administration, spontaneous LH surge, and cases of marked sperm abnormalities. INTERVENTIONS: Controlled ovarian hyperstimulation was achieved using three types of ovarian stimulation protocols: clomiphene citrate (CC) and hMG (n = 35). hMG alone (n = 35) or GnRH agonist and FSH and hMG (n = 30). Thirty-six hours after hCG administration, patients were assigned randomly to either IUI (group A, n = 50) or fallopian tube sperm perfusion (group B, n = 50). Intrauterine insemination was performed with 0.2 mL of sperm suspension according to a standard technique. Fallopian tube sperm perfusion was performed using a simple and reliable system that ensures a good cervical seal and allows to a pressurized injection of 4 mL of sperm suspension. MAIN OUTCOME MEASURES: Feasibility of the fallopian tube sperm perfusion method, clinical pregnancy (presence of gestational sac with heart beats at 6 weeks of amenorrhea), and ongoing pregnancy rates (PRs) (> 12 weeks of amenorrhea), incidence of complications (multiple pregnancies and ovarian hyperstimulation syndrome [OHSS]). RESULTS: Overall, the new fallopian tube sperm perfusion system was simple to handle and well tolerated by patients. In group A, we observed 10 clinical pregnancies (20% per cycle) of which 7 were ongoing (14%). In group B, 20 clinical pregnancies (40% per cycle) of which 17 ongoing pregnancies (34%) were obtained. These differences were statistically significant. The prevalence of twin and three or more sac pregnancies was similar in the two groups (3/10 and 0/10, respectively, in group A, and 5/20 and 2/20, respectively, in group B). No case of moderate or severe OHSS was observed in this series. CONCLUSIONS: Our results indicate that the new system for fallopian tube sperm perfusion is not only simple and reliable but also may lead to PRs twice as high as standard IUI in COH cycles.

Adult↗