Hernández MA, Pacheco PR, Estrada HMR, García JE, Polanco GJC

Language: Spanish
References: 10
Page: 118-124
PDF size: 289.08 Kb.

ABSTRACT

The primary fallopian tube invader adenocarcinoma is a preoperative diagnosis rarely reported in the literature, because is the most uncommon of all gynecological tumors, with prevalence from 0.3 to 1.8%. Since its clinical evolution is very unspecific, in general this tumor is diagnosed during a laparothomy for other purpose or by the pathologist in the final histopathological report. The most frequent signs and symptoms are abdominal pain or a pelvic mass in 80% of cases; transvaginal bleeding in 50%, intense transvaginal serohematic discharge (hidrops tubae profluens) in 11.1%, and peritonitis in pelvis in 3.7%. In 25 to 60% of the cases a report of adenocarcinoma in the pap smear with negative endometrial biopsy can be found. The treatment is predominantly surgical, as that of epithelial ovarian carcinoma, and consists of an intraperitoneal washing, total abdominal hysterectomy with bilateral salpingo-oophorectomy and a proper staging. It is required an omentectomy with pelvic and paraaortic lymphadenectomy in systematic way. In the more advanced stages III and IV that required a radical debulking, we have to be very emphatic in citoreduction. In some cases, as the persistence or recurrence of illness, it can be necessary adjuvant chemotherapy. In some patients in early stage I or II with low risk, the complete staging could not be necessary. There is controversy about administration criteria of adjuvant treatment, since there is not evidence of survival increase related to its use. The five years survival rate was 64% for stage I, 42% for stage II, 32% for stage III, and 17% for stage IV. Fallopian tube malignancies are rare and involve a poor prognosis.

REFERENCES

1. Sica A, Porro V, Rodríguez Álvarez MC, Álvarez Santin C. Tumores primarios de trompa uterina. Arch Gynecol Obstet 2006;44(2).

2. Giménez M, Bracho G, Borges A, García G. Adenocarcinoma primario de trompa uterina, a propósito de un caso y revisión de la literatura. Rev Venez Oncol 2005;6:1-7.

3. Ko ML, Jeng CJ, Chen SC, Tzeng CR. Sonographic appearance of Fallopian tube carcinoma. J Clin Ultrasound 2005;33(7):372-4.

4. Pallas M, Rosen B, Chapman W, Wilson S. Sonographic diagnosis of primary malignant tumors of the fallopian tube. Ultrasound Q 2004;20:59-65.

5. Singhal P, Odunsi K, Rodabaugh K, Driscoll D, Lele S. Primary fallopian tube carcinoma: a retrospective clinicopathologic study. Eur J Gynecol Oncol 2006;27(1):16-18.

6. Semrad N, Watring W, Fu YS, Hallatt J, Ryoo M, Lagasse L. Fallopian tube adenocarcinoma: common extra peritoneal recurrence. Gynecol Oncol 1986;24(2):230-5.

7. Culton LK, Deavers MT, Silva EG, Liu J, Malpica A. Endometrioid carcinoma simultaneously involving the uterus and the fallopian tube, a clinicopathologic study of 13 cases. Am J Surg Pathol 2006;30:844-9.

8. Kindelberger OW, Lee Y, Miron A, Hirsch MS et al. Intraepithelial carcinoma of the fimbria and pelvic serous carcinoma: Evidence for a causal relationship. Am J Surg Pathol 2007;31(2):161-9.

9. Medeiros F, Muto M, Lee Y, Elvin, J, Callahan M. The tubal fimbria is a preferred site for early adenocarcinoma in women with familial ovarian cancer syndrome. Am J Surg Pathol 2006;30:230-6.

10. Puig F, Lapresta M, Lanzon A, Crespo R. Fallopian tube carcinoma: incidental finding during surgery for acute pelvic inflammatory disease-case report. Eur J Gynaecol Oncol 2006;27(5):526-7.