Clinical Experience of 6 Cases of Primary Tubal Cancer

Abstract

Objective : Primary tubal cancer is a rare tumor that histologically and clinically resembles primary ovary cancer. The purpose of this study was to evaluate the clinical experience of 6 patients with primary tubal cancer. Methods : The following parameters were assessed: age, menstruation history, parity, PAP smear status, presenting symptoms, serum CA-125 levels, characteristic sonographic findings, accuracy of preoperative diagnosis, mode of surgery, lymph node metastasis, presence of ascites, tumor grade, stage, and administered postoperative chemotherapy. The 6 patients with primary tubal cancer were diagnosed and treated at the Department of Obstetrics and Gynecology, Ajou Medical Center from March 1998 to March 2004. Results : The mean age was 53.3 years. The presenting symptoms consisted of vaginal spotting, abdominal pain, abdominal discomfort, and dyspnea. Only one patient was preoperatively diagnosed as primary tubal cancer, while the remaining 4 patients were diagnosed as primary ovary cancer. The postoperative pathology revealed 5 cases of serous papillary adenocarcinoma and 1 case of primary transitional cell carcinoma. Three patients were stage III, while the rest were stages I, II, and IV, respectively. Multi-drug chemotherapy was administered to all six patients postoperatively. Follow-up comprised serial serum CA-125 level measurements and computerized tomography scans. Conclusion : Primary tubal cancer is rarely diagnosed preoperatively. The treatment approach is similar to that of ovarian cancer, and includes primary surgical staging operation comprising total abdominal hysterectomy, bilateral salpingo-oophorectomy, and postoperative adjuvant chemotherapy. The prognosis is similar to that of primary ovarian cancer.