Fallopian tube carcinoma: an under-recognized primary neoplasm

Abstract

It has been suggested that primary carcinoma of the fallopian tube may be more common than has previously been recorded. To investigate this possibility further a clinico-pathological study was undertaken at The Northern General Hospital, Sheffield. All cases undergoing primary surgical treatment for ovarian cancer at this regional Gynaecological Oncology unit were reviewed by one pathologist. Between January 1994 and October 1995, 36 new cases of epithelial ovarian cancer were diagnosed at laparotomy. During this time period three women, all of whom lived in the local catchment area, had a diagnosis of primary fallopian tube carcinoma established by accepted pathologic criteria. One case was an incidental finding at the time of hysterectomy for benign disease. Another presented as cervical lymphadenopathy, which contained metastatic papillary serous carcinoma, subsequently demonstrated at operation to be of tubal origin. Over a 22 month period the ratio of primary tubal to ovarian carcinoma in our surgical population was 10 times that predicted by national incidence figures. The manner of presentation of two of the cases of tubal carcinoma raises the possibility that in other circumstances they may not have been recorded as such. If primary tubal carcinoma is under-reported, there may be implications to the nature of the procedure performed as surgical prophylaxis against ovarian cancer.