Metastasis of fallopian tube carcinoma to the thyroid gland: A case report

Background: Primary fallopian tube carcinoma (PFTC) is a rare gynecological malignancy though its prevalence may be underestimated given that most ‘ovarian’ serous cancers originate in the fallopian tube. Its diagnosis is challenging due to its vague signs and symptoms on presentation and it is frequently under-diagnosed pre-operatively. Case Presentation: We present a case of a pre-menopausal woman who presented with vaginal bleeding. Her laboratory testing and physical examination were grossly unremarkable. Gynecologic ultrasound demonstrated multiple uterine fibroids and a double layer endometrium measuring 4.5 mm. More importantly, the left ovary was seen with a complex cyst with mildly echogenic fluid and a solid excerscence. These findings were suspicious for malignancy. The clinical and radiological findings with elevated CA-125 were consistent with a malignant process. Patient subsequently underwent a diagnostic laparoscopy, which required conversion to exploratory laparotomy, supracervical hysterectomy, bilateral salpingo-oophorectomy, right ureteral lysis, right para-aortic and right pelvic lymph node debulking and omentectomy. Biopsy of left fallopian tube and ovary revealed invasive high-grade serous carcinoma of fallopian tube, with involvement of lymphovascular spaces and with surface involvement. Peritoneal washings were negative for malignancy. She was diagnosed with a high-grade serous carcinoma of the fallopian tube after undergoing an endometrial biopsy, multiple imaging tests and finally surgical intervention that yielded the diagnosis. She was started on chemotherapy with carboplatin and paclitaxel. Conclusion: Our aim is to highlight the importance of having PFTC among the differential diagnosis when women present with vaginal bleeding or abdominal pain, as the clinical presentation of PFTC tends to be non-specific, and is often under-diagnosed; reviewing the diagnosis and management, and characterizing the similarities and differences of PFTC with other gynecological malignancies such as ovarian cancer.

: Primary carcinoma of the fallopian tube is a rare, but fatal gynecologic cancer. The preoperative diagnosis of this carcinoma is challenging due to the absence of specific symptoms and signs, and in most patients, it is an intraoperative finding. A 55-year-old patient (G3Ab1P2) was referred to the urogynecology clinic of our hospital with the chief complaints of heavy, prolonged menstrual bleeding and a persistently abnormal yellow discharge, which could not be distinguished by the patient from urinary leaks. After a complete diagnostic work-up, the patient was identified as a candidate for hysterectomy due to abnormal vaginal bleeding resistant to megestrol acetate, family history of malignancy, and abnormal vaginal discharge. Laparotomy revealed unusual left fallopian tube features (large, bulky, and vegetative), suggesting malignancy. The intraoperative frozen-section analysis of the left fallopian tube and the ovarian specimens indicated the mass as a high-grade serous carcinoma of the fallopian tube. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, and partial omentectomy were performed for the patient. The definitive histopathological diagnosis was high-grade serous carcinoma of the left fallopian tube (stage 2b) with omental involvement, without any evidence of lymphovascular invasion. High-grade serous carcinoma of the fallopian tube is likely to have non-specific symptoms, causing a significant delay in diagnosis and treatment, which negatively affects the prognosis and survival of these patients.

Are RTOG Para-aortic Contouring Guidelines for Pancreatic Neoplasm Applicable to Other Malignancies?: Assessment of Nodal Distribution in Gynecological Malignancies

Carcinomas other than adenocarcinomas are extremely rare in the fallopian tube. A 42-year-old woman with watery, intermittent vaginal discharge was found to have a left adnexal tumor. This case was diagnosed as primary carcinoma of the fallopian tube, FIGO Stage Ia. She underwent a total abdominal hysterectomy, a bilateral salpingo-oophorectomy, a pelvic and periaortic lymphoadenectomy, and an omentectomy, followed by cisplatin-based chemotherapy. Four years after the initial diagnosis of the disease, she remains in a disease-free state. Histologically, the tumor revealed a primary transitional cell carcinoma of the left fallopian tube. The findings on an immunohistochemical test for an epithelial membrane antigen, the CA125 antigen, were positive, whereas findings on a test for CEA were negative. We report a case of a malignant neoplasm of the fallopian tube with histological features of transitional cell carcinoma that arose from the tubal epithelium.

Primary serous ovarian carcinoma (OVCA) and serous Fallopian tube carcinoma (FTC), both belonging to the BRCA-linked tumour spectrum, share many properties and are treated similarly. However, a detailed molecular comparison has been lacking. We hypothesized that comparative genomic studies of serous OVCAs and FTCs should point to gene regions critically involved in their tumorigenesis. Array comparative genomic hybridization (array CGH) analysis indicated that serous OVCAs and serous FTCs displayed common but also more distinctive patterns of recurrent changes. Targeted gene identification using a dedicated multiplex ligation-dependent probe amplification (MLPA) probe set directly identified EIF2C2 on 8q as a potentially important driver gene. Other previously unappreciated gained/amplified genes included PSMB4 on 1q, MTSS1 on 8q, TEAD4 and TSPAN9 on 12p, and BCAS4 on 20q. SPINT2 and ACTN4 on 19q were predominantly found in FTCs. Gains/amplifications of CCNE1 and MYC, often in conjunction with changes in genes of the AKT pathway, EVI1 and PTK2, seemed to be involved at earlier stages, whereas changes of ERBB2 were associated with advanced stages. The only BRCA1-mutated FTC shared common denominators with the sporadic tumours. In conclusion, the data suggest that serous OVCAs and FTCs, although related, exhibit differences in genomic profiles. In addition to known pathways, new genes/pathways are likely to be involved, with changes in an miRNA-associated gene, EIF2C2, as one important new feature. Dedicated MLPA sets constitute potentially important tools for differential diagnosis and may provide footholds for tailored therapy.

Metastases to the breast from a nonmammary primary are rare. Primary fallopian tube carcinoma is one of the rarest malignancies of the female genital tract. Therefore, breast metastases from primary fallopian tube carcinoma are considered extremely rare.In this article, we shared the case of serous carcinoma of fallopian tube with metastasis to an intramammary lymph node, presenting as a solitary breast mass. On initial staging18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography for this patient with serous carcinoma of fallopian tube, a solitary FDG avid breast mass was found, along with FDG avid multistation nodes. The breast mass was evaluated with diagnostic mammogram and ultrasound and eventually biopsy of this mass revealed metastatic lymph node from carcinoma of fallopian tube origin.

Introduction/BackgroundMultiple primary malignant tumors (MPMT) are defined as two or more independent primary malignancies from different sites and are of different histologies in the same individual2. Incidence of MPMTs ranges...

Primary fallopian tube carcinoma is an extremely uncommon neoplasm of the female genital tract. Primary Fallopian Tube Carcinoma (PFTC) has a clinical and a histological resemblance to Epithelial Ovarian Cancer (EOC). We are reporting a case of PFTC in a 55 year old tubectomized, postmenopausal woman with the non-specific complaints of a watery vaginal discharge and lower abdominal pain. The clinical and radiological findings suggested a bilateral tubo-ovarian abscess. On laprotomy, a bilateral fallopian tube tumour was seen, with a focal extension to the surface of the right ovary from the right fallopian tube. Total abdominal hysterectomy, bilateral adnexectomy andomentectomy, along with excision of the draining lymph nodes, was done. The histopathological examination revealed a bilateral papillary serous carcinoma of the fallopian tube. The patient was treated with adjuvant chemotherapy with Paclitaxel. There was no evidence of any recurrence, after 2 years of regular follow up. The clinical signs and symptoms of fallopian tube neoplasms are usually non-specific. The primary treatment remains a surgical resection, followed by adjuvant chemotherapy or radiation. The prognosis is poor, although long-term survivors have been reported.

Primary fallopian tube carcinoma and ectopic pregnancy: A rare co-occurrence

Introduction: Primary carcinoma of the fallopian tube is very rare among primary genital tract malignancies. Transitional cell carcinoma is among the rarest tumor subtypes that can involve the fallopian tube. Case Presentation: Here, we reported a 42-year-old premenopausal lady presenting with spotting, dysmenorrhea, and abdominal pain. She was found to have a pelvic mass in the right posterior cul-de-sac suspicious to be an eccentrically located leiomyoma. Histopathology examination of the resected mass revealed transitional cell carcinoma arising from the fallopian tube. Conclusions: Primary fallopian tube tumors could be considered in differential diagnosis of pelvic mass and intraoperative frozen consultation is useful for correct diagnosis.

Introduction/BackgroundFallopian tube carcinoma is rare, accounting for approximately 0.2% of cancers among women. It has been suggested that many cases of ovarian carcinoma may actually arise from the epithelial lining...

We report a case of simultaneous Squamous cell carcinoma(SCC) of cervix and fallopian tube (invasive). Primary carcinoma of the fallopian tube is a rare neoplasm, accounting for only 0.3–1.1% of all gynecological malignancies [1]. Adeno-carcinoma is the predominant type and is included in the criteria established by Finn and Javert for diagnosis of primary carcinoma of fallopian tube [2]. Other cell types, including adeno-squamous, endometriod, and malignant mixed mullerian tumour, have also been reported [2].

We encountered a case of recurrent fallopian tube carcinoma in situ with para-aortic lymph node metastasis 9 months after the first surgery. The patient presented with genital bleeding, and endometrial cytology revealed extrauterine malignant cells. However, endometrial biopsy and imaging modalities could not detect any abnormalities. We performed a total abdominal hysterectomy and bilateral salpingo-oophorectomy after obtaining the patient’s consent. Histopathological examination revealed atypical cells in the fimbrial portion of the fallopian tube. A diagnosis of fallopian tube carcinoma in situ was made. No further adjuvant treatment was administered. Nine months later, fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography revealed pathologic activity in the para-aortic lymph node and CA125 elevation. A diagnosis of metastatic adenocarcinoma was established on the basis of histological examination of a frozen section. The patient underwent para-aortic and pelvic lymph node dissection and omentectomy. The pathology report revealed metastasis to 3 of 69 lymph nodes; however, peritoneal cytology was negative for cancer. To the best of our knowledge, this is the first reported case of recurrent fallopian tube carcinoma in situ.

Background: Primary fallopian tube cancer is an extremely rare gynecological malignancy. Aim: To discuss, through a case report, the diagnostic process by means of cytology immunohistochemistry. Case Presentation: A 47-year-old Japanese woman, who also had lung cancer, presented with enlarged para-aortic lymph node without any symptoms. Based on the vaginal cytology report suggestive of gynecologic malignant tumor (possibly fallopian tube adenocarcinoma), primary surgery comprised of total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed. Histopathology and immunohistochemistry examinations revealed primary fallopian tube carcinoma with metastasis of para-aortic lymph node. She is free from recurrence and metastases 9 months after the surgery and chemotherapy. Conclusion: Although primary fallopian tube cancer is a rare gynecologic malignancy, vaginal cytology may be useful for detecting fallopian tube carcinoma.

Peritoneal carcinosarcoma is a highly aggressive and uncommon neoplasm that has carcinomatous and sarcomatous components; the malignancy rarely localizes to the omentum. We report a case of a bulky peritoneal carcinosarcoma with tiny high-grade serous carcinoma of the fallopian tube. A 60-year-old female with a huge pelvic mass (12cm in diameter) underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy, and omentectomy for tumor debulking. Pathological findings showed minimally invasive high-grade serous carcinoma of the left fallopian tube and carcinosarcoma of the omentum. Similar p53 diffuse immunostaining in the omental carcinosarcoma and the tubal carcinoma provides evidence for a clonal relationship between the two neoplasias. This case suggests a small serous carcinoma, originating in the tubal mucosa, subsequently became implanted in the omentum and grew preferentially, converting to a carcinosarcoma at a remote site.