Ultrasonography imaging feature of primary fallopian tube carcinoma and the reason of misdiagnosis analysis

Abstract

Objective To analyze ultrasonographic imaging feature of primary fallopian tube carcinoma (PFTC) and the reasons for misdiagnosis. Methods Clinical data and ultrasonographic imaging feature of 41 patients with pathologically confirmed PFTC were retrospectively analyzed from August 2008 to November 2016 in General Hospital of Chinese People′s Liberation Army. Results Ultrasonographic characteristics of 41 PFTC cases: (1) TypeⅠ(6 cases), the cystic adnexal mass with single or multiple papillary projections and circuity tubular structures, color Doppler flow imaging showed abundant blood flow signal inside the nipples. (2) TypeⅡ(2 cases), the sausage shaped complex adnexal mass showed clear boundary, the cystic area that lined along the fallopian tube was around or at the side of the solid part, color Doppler flow imaging showed rich or abundant blood flow signal inside the solid part. (3) Type Ⅲ (13 cases), the sausage shaped hypoechoic adnexal mass showed clear boundary, color Doppler flow imaging showed rich or abundant blood flow signal inside the mass. (4) TypeⅣ (14 cases), the single or multiple adnexal masses showed irregular surface, with predominant solid components, color Doppler showed rich or abundant blood flow signal inside the tumor; the normal ovarian structure was not detected in unilateral or bilateral adnexa area; and one or more signs of metastasis were found, such as the peritoneal thickening of vesicouterine pouch, uterine rectum pouch and omental, metastasis to other distant organs, and so on. (5) Type Ⅳ(6 cases), only hydrosalpinx or no abnormal ultrasonographic changes in the adnexal area. Nineteen (46.3%, 19/41) cases were correctly diagnosed by preoperative ultrasonography, while 22 (53.7%, 22/41) cases were missed or misdiagnosed. Conclusions Ultrasonography imaging of PFTC has certain characteristics, but it tends to be missed or misdiagnosis when the lesion is small. Ultrasound can show the location, size, internal echo, blood flow and distant metastasis of lesion, which can be taken as the first choice of imaging methods for preoperative diagnosis and postoperative follow-up of PFTC. Key words: Ultrasonography; Fallopian tube neoplasms; Diagnostic errors