A case of recurrent fallopian tube carcinoma in situ with para-aortic lymph node metastasis

Abstract

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.

Ovarian surveillance including endometrial cytology for patients with hereditary breast and ovarian cancer before risk‐reducing salpingo‐oophorectomy: A retrospective analysis

“…Our study is novel as it is based on surveillance limited to patients with HBOC and follows a surveillance protocol that anticipates the utility of endometrial cytology from a previous study. 23 In that study, all patients with an abnormal endometrial cytology developed ovarian cancer. These results suggest that ovarian cancer can be diagnosed at an advanced but asymptomatic status; thus, cancer detection by surveillance, including endometrial cytology, can be effective.…”

“…Endometrial cytology is performed on the basis of the clinical observation from a published report regarding the relationship between endometrial cytology and fallopian tube cancer. 23 This study aimed to comprehensively explore the clinical features of patients who underwent this type of surveillance at our institution.…”

“…At our institution, we suggest that patients with HBOC undergo ovarian surveillance every 3 months, combined with measurements of serum CA‐125, transvaginal ultrasonography, and semi‐annual uterine endometrial cytology. Endometrial cytology is performed on the basis of the clinical observation from a published report regarding the relationship between endometrial cytology and fallopian tube cancer 23 . This study aimed to comprehensively explore the clinical features of patients who underwent this type of surveillance at our institution.…”

Primary fallopian tube carcinoma with isolated appendiceal metastasis: A case report and review of literature

“…As with ovarian carcinoma, PFTC can spread by cell exfoliation to the peritoneum, contiguous invasion, transluminal migration, and hematogenous or lymphatic spread [4][5][6]. In particular, the abundant supply of lymphatics to the fallopian tube contributes to more frequent lymph node metastasis, even when the tumor is apparently confined to the fallopian tube [10,11,19]. The appendix is a common site for EOC because of its proximity to the right ovary and adjacent paracolic space, where ascites drains [20].…”

“…PFTC and ovarian carcinoma use similar mechanisms -cells exfoliate to the peritoneal cavity, and there's sustained invasion characterized by transluminal migration, hematogenous dissemination, or by lymphovascular invasion as cancer cells break into blood vessels or lymphatic channels [4][5][6]. Distant metastasis is extremely rare, and only a few cases have been reported previously [7][8][9][10][11]. This is the first documented case of PFTC associated with appendiceal metastasis.…”