Serous adenocarcinoma of the fallopian tube: a case report

Abstract

Objective: Primary serous adenocarcinoma of the fallopian tube (PSAFT) is a rare tumor which histologically and clinically resembles epithelial ovarian cancers. Although it has been postulated that both ovarian and tubal high-grade serous carcinomas actually share common histogenesis, PSAFT has a worse prognosis than ovarian cancer. We report a case of PSAFT that presented clinically as hydrosalpinx. Material and Methods: A 62-year-old patient with complaints of a low abdominal pain and vaginal discharge was admitted at the gynecological department. During the diagnostic procedure, the ultrasound examination revealed uterine fibroid and a right-sided hydrosalpinx. The patient underwent hysterectomy with bilateral adnexectomy. Due to the clinical assessment of benign disease, no tumor markers were required preoperatively, nor biopsy from the omentum and parietal peritoneum, as well as peritoneal washing, were obtained intraoperatively. The operative material was routinely dissected and a standard procedure for histology and immunohistochemistry was performed. Results: The right tube was tortuous, 17 cm in length, having 5 cm long dilatation in the proximal third. In the dilated part, few exophytic, neoplastic, white-grayish soft lesions were found. The histopathologic examination revealed areas of in situ as well as high-grade PSAFT with lamina propria involvement. The malignant cells were positive for CK7 and WT1. The tumor did not infiltrate the muscle layer, so it was defined as FIGO stage IA. The leiomyoma previously diagnosed by ultrasound was histologically confirmed, while the left adnexa and right ovary revealed regular morphology and were free of tumor. Two months after the operation the patient is in good health and diseasefree. Conclusions: PSAFT should be distinguished as a different clinical entity from primary ovarian epithelial neoplasms so that the patient could receive adequate therapy and follow-up.