Carcinoma, fallopian tube

the rarest of female genital tract malignancies, accounting for less than 1%. Almost all Fallopian tube cancers are adenocarcinomas. Primary Fallopian tube cancers account for only about 10% of malignancies found at this site, the rest being secondary lesions. Common primary sites are the ovary, uterus and gastrointestinal tract. Primary adenocarcinomas of the Fallopian tube may affect virtually any age, but most patients are over 50. Possible risk factors include low parity, infertility and pelvic inflammatory disease. The diagnosis of primary Fallopian tube carcinoma is usually made only at surgery, in a patient undergoing exploratory laparatomy for suspected intra-abdominal malignancy. Occasionally, a postmenopausal woman presents with abnormal vaginal discharge and bleeding, combined with lower abdominal pain and an adnexal mass. This complex of clinical findings is said to be diagnostic.

At imaging, by ultrasound, CT, or MRI, tubal carcinoma is seen as a nonspecific solid adnexal mass. Bilateral disease is rare. The ovary may not be visible separate to the mass, because of either compression or postmenopausal atrophy. Therefore, the extraovarian origin of the tumour may not be appreciated. Even at surgery, it may be difficult to distinguish ovarian from Fallopian tube cancer. Sometimes the configuration of the tumour resembles a hydrosalpinx, and this may suggest the correct diagnosis. Fallopian tube adenocarcinoma spreads within the peritoneal cavity, to lymph nodes, and by haematogenous distribution. Peritoneal and nodal metastases are best detected by CT or MRI.

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