Small fallopian tube carcinoma with extensive upper abdominal dissemination: a case report

Abstract

IntroductionFallopian tube carcinoma is a rare gynecological malignancy with low accuracy detection preoperatively. The symptoms are unspecific and imaging can be misleading. Since it was first described in 1847, there have been only a little over 2000 case reports.Case presentationThis case report describes a 66-year-old Caucasian woman who presented with progressive diffuse abdominal pain, without other symptoms. After abdominopelvic magnetic resonance imaging, she was sent to the Portuguese Oncology Institute of Oporto with the suspicion of peritoneal carcinomatosis of unknown primary tumor. Due to a pelvic palpable mass (calcified giant uterine fibroid) she was directed to the Gynecology team. Surgery was performed and a large mass in her upper abdomen was identified. The extemporary examination revealed a high-grade adenocarcinoma. During surgery a small change of color and consistency of her left fallopian tube was noted and unilateral adnexectomy was performed. After pathologic and immunohistochemistry tests, the diagnosis of fallopian tube carcinoma with peritoneal dissemination was made.ConclusionsThis case is very unique in the way that a small primary fallopian tube carcinoma was able to disseminate to the upper abdominal quadrant with little pelvic dissemination. The symptoms and imaging were unspecific. Although a rare occurrence, we should not forget fallopian tube carcinoma in the differential diagnosis of peritoneal carcinomatosis, even in the absence of Latzke’s triad.

Serous Adenocarcinoma of Fallopian Tubes: Histological and Immunohistochemical Aspects

“…Numerous scientific publications on PCFT include single observations of this disease [15,16]. Patients with malignant FT neoplasms are typically older, which may be due to increased amount of secretory cells in older women [17,18].…”

The case of synchronous fallopian tube and endometrium cancer. Clinical observation

“…To date, in the United States about 2,000 cases of the PFTC were reported [10]. FTC is the most often found after the fourth decades of the life, with an average age of 62 years (17-88 years) [11,12].…”

Clinically occult primary fallopian tube carcinoma presenting as a malignant pleural effusion

“…PFTC has the ability to metastasize by a variety of mechanisms. Like ovarian malignancy, transcoelomic spread can lead to the dreaded complication of peritoneal carcinomatosis and can happen despite small tumour size because physical breach is not required . MPEs in this setting are believed to result from the deposition of neoplastic cells into the pleural cavity as a result of transdiaphragmatic migration of malignant peritoneal fluid.…”