Primary carcinoma of the fallopian tube: A clinicopathologic analysis of 27 patients.

Objective: To analyze the clinicopathologic features of women with primary fallopian tube carcinoma

Methods: Descriptive cross sectional study Methods: Twenty-eight women diagnosed with primary fallopian tube carcinoma treated at Chiang Mai University Hospital between January 1997 and December 2004.

Results: During the study period, the primary fallopian tube carcinoma accounted for 0.48% of all gynecologic malignancies. Of the 28 patients, one was excluded for unavailable medical records. Mean age at diagnosis was 53 years (range, 38-76 years). Seventeen (63.0%) were menopausal women. The most common clinical presentation was pelvic mass (55%), followed by abnormal vaginal bleeding (18.5%). Hydrops tubae profluens was present in three (11.1%) women. The rare presenting symptoms included pelvic peritonitis and abnormal glandular cells on cervicovaginal smear were noted in one (3.7%) woman of each category. In all women, primary fallopian tube carcinoma could not be diagnosed preoperatively. During the operation, an abnormal tubal lesion was suspected in only eleven (40.7%) women. Histology were serous adenocarcinoma (70.4%), endometrioid adenocarcinoma (22.2%), undifferentiated adenocarcinoma (3.77%) and carcinosarcoma (3.7%). As opposed to epithelial ovarian cancer, the majority of women in the present study were in the early stages of the disease.

Conclusions: Primary fallopian tube carcinoma is a rare gynecologic malignancy that has various and nonspecific presentations. Definite diagnosis is usually made postoperatively. This malignancy should be considered in differential diagnosis of peri- and postmenopausal women who present with complex adnexal mass, unexplained uterine bleeding, abnormal glandular cells on cervicovaginal smear and complicated pelvic inflammatory disease.