High-grade serous carcinoma of the fallopian tube in a young woman with chromosomal 4q abnormality:A case report

BACKGROUND Few studies have reported an association between an increased risk of acquiring cancers and survival in patients with 4q deletion syndrome.This study presents a rare association between chromosome 4q abnormalities and fallopian tube highgrade serous carcinoma(HGSC)in a young woman.CASE SUMMARY A 35-year-old woman presented with acute dull abdominal pain and a known chromosomal abnormality involving 4q13.3 duplication and 4q23q24 deletion.Upon arrival at the emergency room,her abdomen appeared ovoid and distended with palpable shifting dullness.Ascites were identified through abdominal ultrasound,and computed tomography revealed an omentum cake and an enlarged bilateral adnexa.Blood tests showed elevated CA-125 levels.Paracentesis was conducted,and immunohistochemistry indicated that the cancer cells favored an ovarian origin,making us suspect ovarian cancer.The patient underwent debulking surgery,which led to a diagnosis of stage IIIC HGSC of the fallopian tube.Subsequently,the patient received adjuvant chemotherapy with carboplatin and paclitaxel,resulting in stable current condition.CONCLUSION This study demonstrates a rare correlation between a chromosome 4q abnormality and HGSC.UBE2D3 may affect crucial cancer-related pathways,including P53,BRCA,cyclin D,and tyrosine kinase receptors,thereby possibly contributing to cancer development.In addition,ADH1 and DDIT4 may be potential influencers of both carcinogenic and therapeutic responses.

Primary ovarian cancer combined with primary fallopian tube cancer:A case report

BACKGROUND Low grade serous carcinoma of the ovary(LGSOC)is a rare type of epithelial ovarian cancer with a low incidence rate.The origin of ovarian cancer has always been a hot topic in gynecological oncology research,and some scholars believe that the origin of ovarian malignant tumors is the fallopian tubes.Primary fallopian tube cancer is the lowest incidence of malignant tumors in the female reproductive system.There are only a few reports in the literature,but the mortality rate is very high.But in clinical practice,fallopian tube cancer is very common,but in most cases,it is classified as ovarian cancer.CASE SUMMARY We report a 54 years old postmenopausal woman who was hospitalized with a lower abdominal mass and underwent surgical treatment.The final pathological confirmation was low-grade serous carcinoma of the right ovary and low-grade serous carcinoma of the left fallopian tube.No special treatment was performed after the surgery,and the patient was instructed to undergo regular follow-up without any signs of disease progression.CONCLUSION The prognosis of LGSOC is relatively good,over 80%of patients still experience disease recurrence.

Endometriosis-associated endometrioid adenocarcinoma of the fallopian tube synchronized with endometrial adenocarcinoma:A case report

BACKGROUND Endometriosis is a common gynecological disorder that affects women of reproductive age.It is characterized by a cancer-like invasion of the extra-uterine endometrium and exhibits a strong association with ovarian clear cell cancer and endometrioid cancer.Endometriosis-associated fallopian tube endometrioid adenocarcinoma synchronized with endometrial adenocarcinoma was rarely reported.CASE SUMMARY A 49-year-old woman was referred to our hospital complaining about abnormal vaginal bleeding for three years following unsatisfactory medication.Intraop-erative frozen sections unexpectedly unveiled an endometrioid cancer of the left fallopian tube with superficial invasion surrounded by diffuse endometriosis synchronized with endometrioid endometrial cancer.CONCLUSION It was difficult to make a differential diagnosis when confronted with incidental findings of fallopian tube cancer lesions synchronized with endometrial cancer.The key differential diagnosis of primary endometriosis-associated endometrioid adenocarcinoma of the fallopian tube from endometrial adenocarcinoma invol-vement relies on the pathological identification of malignant transformation in fallopian tube endometriosis disease.

The Interest of Endoscopy in the Diagnosis of Fallopian Tubes Diseases at the Yaoundé Gyneco-Obstetric and Pediatric Hospital (Ygoph)

Introduction: Fallopian diseases are often implicated in female infertility. Several radiological and surgical explorations have been proposed in order to evaluate the severity of lesions found in utero-adnexal pathology. Among tools that are used to investigate such pathologies, we have ultrasound, hysterosalpingography and endoscopy. But, in many developing countries like Cameroon, the usage of endoscopy in gynecology is not yet known by many practicians. The objective of our study was to show the interest of endoscopy in the diagnosis of fallopian tube pathologies. Methodology: We conducted a cross-sectional and descriptive study from March 1st, 2017 to May 31st, 2017 at the Gyneco-Obstetrics and Pediatric department of our Hospital. We included all women who presented infertility and underwent ultrasound, hysterosalpingography (HSG) and endoscopy at the Yaoundé Gyneco-obstetrics Hospital. We analyzed epidemiological parameters, clinics, ultrasound, hysterosalpingography and endoscopic finding. We used Cohen’s Kappa test to determine the correlation between HSG/endoscopy and ultrasound/endoscopy in the diagnosis of fallopian tube pathologies. The threshold was significant for a K-value > 0.20. Results: We got a sample of 156 women;the mean age was 32.6 ± 4.5 years. The Secondary infertility dominated in 66.7% of cases;31.1% of women presented a past medical history of sexually transmitted infections and 41.7% did abortions before. Endoscopic lesions were dominated by a fallopian obstruction in 54.5% of cases, 8.3% of adhesions, 33.9% of women presented uterine myomas, 37.8% of ovarian cysts and 1.3% of pelvic endometriosis. The K-values between HSG and endoscopy for distal and proximal tube obstructions were significant with respective thresholds of 0.25 and 0.30. The K-value between ultrasound and endoscopy was not significant with a threshold of 0.015 for the tubal hydrosalpinx. Conclusion: Endoscopy assessment appears as the most efficient tool to investigate fallopian tube diseases.

Acute abdomen in pregnancy due to isolated Fallopian tube torsion: The laparoscopic treatment of a rare case

In the last years, operative laparoscopy became a standard approach in gynaecology and general surgery. Even in pregnancy its use is becoming more widely accepted. In fact, it offers advantages similar to those in no pregnant women, associated with good maternal and fetal outcomes. Around 0.2% of pregnant women require abdominal surgery. The most common indications of laparoscopy in pregnancy are cholelithiasis complications, appendicitis, persistent ovarian cyst and adnexal torsion. Authors describe a very rare case of acute abdomen due to isolated Fallopian tube torsion in a 24 th weeks pregnant woman, managed by laparoscopic salpingectomy.

Primary mesonephric adenocarcinoma of the fallopian tube:A case report

BACKGROUND Mesonephric adenocarcinoma(MNAC)is an extremely rare malignancy in the female genital tract.Only a few cases have been reported in the literature,and most of them occurred in the cervix,with extremely rare cases in the uterine body and ovary.MNAC has never been reported to arise in the fallopian tube.CASE SUMMARY A 45-year-old woman was referred to our institution with a history of abdominal pain.Ultrasound revealed a cystic and solid mass in left adnexal region.The patient underwent complete staging surgery when intraoperative pathological examination demonstrated that the mass was malignant.The final histological and immunohistochemical results confirmed the diagnosis of MNAC originating from the fallopian tube.Then she received four cycles of combination chemotherapy with carboplatin plus paclitaxel.The tumor recurred with hepatic metastases 4 mo after initial surgery,and second resection of the tumors in the liver plus partial hepatectomy was performed.She was supplemented with five courses of a new combination chemotherapy with gemcitabine plus carboplatin,and there was no evidence of recurrence within the 22-mo follow-up period after the second surgery.CONCLUSION MNAC originating from the fallopian tube is an extremely rare and high malignancy with a poor prognosis.It can be very aggressive,even at early stage.Little is known about the clinical characteristics,pathological diagnosis,prognosis,and optimal management strategy of MNAC originating from the fallopian tube.Herein we report the first case of primary MNAC deriving from the fallopian tube.

FALLOPIAN TUBE PROLAPSE FOLLOWING HYSTERECTOMY

Objective To investigate the clinical diagnosis, treatment, and prevention of fallopian tube prolapse (FTP) after hysterectomy.Methods A total of 7949 patients received hysterectomy from January 1983 to August 2005 in Peking Union Medical College Hospital, and 9 cases (including 1 case from other hospital) of FTP after hysterectomy were involved during this period.All of them were diagnosed according to pathological results and were followed up.The symptoms, diagnosis, and treatment of the FTP patients were analyzed retrospectively.Results The incidence of FTP after hysterectomy was 0.1% (8/7949), with the incidence of FTP after trans- abdominal hysterectomy being 0.06% (4/6229), after trans-vaginal hysterectomy being 0.5% (4/780), after laparoscopic assistant vaginal hysterectomy being 0 (0/940).There was no symptom in 3 cases.The pelvic examination revealed the typical prolapsed fimbrial end of a fallopian tube in 3 cases and the other 6 cases revealed red granulation tissue.All of them were excised vaginally and cauterized.The results were proved by pathological examination.No recurrence was reported during follow-up.Conclusions FTP is a rare complication after hysterectomy.The prognosis is well after proper diagnosis and treatment.Fixation of accessories onto the pelvic wall and complete peritonealization at the time of hysterectomy are the most important methods to prevent FTP after hysterectomy.

Combination of docetaxel-carboplatin for adjuvant chemotherapy of epithelial ovarian,primary peritoneal and fallopian tube cancers:a meta-analysis

Objective： The aim of this study was to compare the efficacies and safeties of the combination of docetaxel- carboplatin with the combination of non docetaxel-carboplatin as first-line chemotherapy for advanced epithelial ovarian, pri- mary peritoneal or fallopian tube cancers. Methods： Relevant articles were identified from MEDLINE （1993-2010）, EMBASE （1980-2010）, MEDION, the Cochrane library, Science Citation Index Expanded databases, hand searching of reference lists from primary articles and reviews, conference abstracts and contact with experts in the field. The review included 5 relevant primary studies （1430 women）. Data was extracted for study characteristics and quality. Bivariate random-effect model meta- analysis was used to estimate diagnostic accuracy of the various index tests. A quantitative meta-analysis was carried out by two reviewers based on the inclusion criteria from all available studies. Results： The frequency of the subgroup analysis of toxicity showed that toxicity action of combination of docetaxel-carboplatin was more severe than that of non docetaxel- carboplatin group （OR = 1.33, 95% CI = 1.13-1.56, P = 0.0005）, whereas that of clinical responses was equivalent in com- parison combination of docetaxel-carboplatin with combination of paclitaxel-carboplatin or docetaxel-cisplatin （OR = 1.0, 95% CI = 0.87-1.16, P = 0.95）. There were heterogeneity （X2 = 79.36, P 〈 0.00001） and inconsistency （83.6%） in toxicity analysis among the trials, while neither heterogeneity （x2 = 3.21, P = 0.99） nor inconsistency （F = 0%） in clinical responses among the trials. Conclusion： The safety of combination of docetaxel-carboplatin is less than that of combination of paclitaxel- carboplatin or docetaxel-cisplatin. However, the clinical responses of combination of docetaxel-carboplatin are comparable with combination of paclitaxel-carboplatin or docetaxel-cisplatin.

Fallopian tube:Its role in infertility and gynecological oncology

Disorders of the fallopian tube play a very important role in both infertility and gynaecological oncology. Tubal factor infertility is considered among the leading causes of female factor infertility. Many tubal disorders are related to infertility including congenital anomalies, acute and chronic inflammatory diseases, endometriosis and other pathologies that result in partial or total fallopian tube obstruction. In the field of gynaecological oncology, ovarian surface epithelial tumors remain one of the most fatal malignancies in women worldwide carrying the worst prognosis among female genital malignancies. For decades, the cell of origin of epithelial tumors has remained controversial and was largely believed to be surface ovarian epithelium. Recently several studies suggested that there is a major role of the fallopian tube in the development of ovarian surface epithelial tumors, mainly high grade serous carcinoma and other tumour types. In this article we review the role of the fallopian tube in both infertility and gynaecological oncology.

Primary Fallopian Tube Adenocarcinoma Discovered with the Vaginal Cytology: A Case Report with Pathological and Immunohistochemical Investigation

Background: Primary fallopian tube cancer is an extremely rare gynecological malignancy. Aim: To discuss, through a case report, the diagnostic process by means of cytology immunohistochemistry. Case Presentation: A 47-year-old Japanese woman, who also had lung cancer, presented with enlarged para-aortic lymph node without any symptoms. Based on the vaginal cytology report suggestive of gynecologic malignant tumor (possibly fallopian tube adenocarcinoma), primary surgery comprised of total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed. Histopathology and immunohistochemistry examinations revealed primary fallopian tube carcinoma with metastasis of para-aortic lymph node. She is free from recurrence and metastases 9 months after the surgery and chemotherapy. Conclusion: Although primary fallopian tube cancer is a rare gynecologic malignancy, vaginal cytology may be useful for detecting fallopian tube carcinoma.

Ultrastructural Observation of Fallopian Tubes in Patients with Pelvic Congestion Syndrome after Oviductal Ligation

The morphological basis of bilateral lower abdominal pain was studied by means of ultrastructural observation in patients with pelvic congestion syndrome after oviductal ligation. Fallopian tubes of 14 cases were collected during operation. Of them, 10 patients suffered from pelvic congestion syndrome, 4 cases were normal used as control, the 8 small segments from the tubal isthmus were removed during ligation. The essential changes of the fallopian tubes in patients with this syndrome were the marked swelling of the C-type unmyelinated nerve fibers, the decrease in density of axoplasm and in number of microtubules and microfilaments. The Schwann's cells were swollen as well. Furthermore, the mitochondria revealed mild to moderate swelling, their cristae decreased and shortened. However, the changes of the endings of efferent nerve fibers were not obvious.The ultrastructural changes of C-type unmyelinated nerve fibers except the endings of efferent nerve fibers were closely related to the bilateral lower abdominal pain in patients with this syndrome.

A CLINICAL REPORT OF REFRACTOTY CARCINOMA OFOVARY AND FALLOPIAN TUBE TREATED WITH TAXOL

From September 1993 through March 1994, 30 cases of refractory carcinoma of the ovary and Fallopian tube were treated with Taxol. Complete response was seen in 4 and partial response in 8 cases with a response rate of 40 %. The average length of remission was 5 months in CR and 3.9 months in PR. The major toxic side effect was decrease in total white cell count and in neutrophil count. Apart from flushing of face during Taxol infusion in 6 patients, no other allergic reaction was observed. Gastrointestinal, neurologic, liver and renal toxicities were mild. Taxol is a drug of choice in the treatment of patients with cancer of the ovary and Fallopian tube who are resistant to conventional chemotherapy.

Recurrent Ectopic Pregnancy in the Remnant Fallopian Tube Following Ipsilateral Partial Salpingectomy

A 39-year-old female with a history of partial salpingectomy for tubal pregnancy was diagnosed as having recurrent ectopic pregnancy in the distal portion of the fallopian tube remnant, which was successfully treated by laparoscopic surgery. The patient was multigravida (9 pregnancies) and uniparous. She had undergone right partial salpingectomy by laparotpmy for right isthmic ectopic pregnancy at the age of 31 years. At 6 weeks of the current pregnancy, she was referred to our hospital for suspected ectopic pregnancy. The gestational sac was not observed in the uterus, and a mass was observed in the right adnexal region by transvaginal ultrasonography. Emergency laparoscopic surgery revealed the pregnancy site in the ampulla of the remnant portion of the right fallopian tube;therefore, this portion was resected. Because the proximal portion of the fallopian tube remnant was completely occluded, we concluded that this was a case of ectopic pregnancy resulting from the intraperitoneal migration of a fertilized ovum. With current developments in assisted reproductive technologies, reanastomosis of the fallopian tube is rarely performed. While partial salpingectomy is less likely to contribute to the preservation of fertility, it increases the risk of recurrent ectopic pregnancy. A single-stage total salpingectomy on the affected side should be the first choice of treatment when fallopian tube preservation surgery is not selected.

Diagnostic and Therapeutic Radiological Intervention for Fallopian Tube Obstruction

Presented in this paper are results of diagnostic and therapeutic radiological intervention for 110 cases of fallopian tube obstruction. Unilateral or bilateral recanalization was achieved in 89 cases, with a success rate being 80. 91%.Among the 89 patients, patency was achieved by first step treatment(regularHSG) in 40 cases (46%) and recanalization was successeful in 49 patients(54%) by sencond and/or third step (selective salpingography plus guide wire). Inthe 49 cases, 96 occluded tubes were involved, including 89 tubes with proximalobstruction (interstitia-isthmus portion) and 7 tubes with medial-distal obstruction (isthmus-ampulla portion). The success rates for proximal and medial-distalobstruction were 92. 2% and 7. 8% respectively. Follow-up results of 45 casesrevealed that the tubes of remained patent in 30 cases; 40 became pregnant, among them, 9 gave normal birth of babies; occlusion re-developed in only onecase. The authors believe that this radiological intervention can avoid false positive findings frequently occurring with use of regular HSG, thereby enhancing diagnostic accuracy. The selective salpingography could directly increase the intratubal hydrostatic pressure , remove the debris and amiliorate the inflammatoryadhersion in the fallopian tubes; selective salpingography plus guide wire recanalization can recanalize the tubes with proximal obstruction with satisfactory results. We recommend the method for the pre-treatment of 'test tube baby' procedure.

Primary Bilateral Adenocarcinoma of the Fallopian Tube: A Case Report

Primary fallopian tube carcinoma is an uncommon malignancy that accounts for 0.14% to 1.8% of gynecological cancers. The clinical symptom is not specific and preoperative diagnosis is easy to miss or delay because of a lack of specific symptoms. We reported a case of bilateral adenocarcinoma of the Fallopian tubes, was occurred in a 51-year-old postmenopausal woman and diagnosed with bilateral salpingectomy for suspicious of suppurative salpingitis. The diagnosis is not always suspected preoperatively. They are assimilated to salpingitis in the early stage, or to ovarian tumors in the advanced stage. The diagnosis is made postoperatively, after an anatomopathological examination. Its etiology is still poorly understood.

A Rare Case of Intrauterine Adhesion Caused by Intrauterine Fallopian Tube Incarceration

Hysteroscopy is widely used for the detection and treatment of intrauterine adhesion.Such technique,however,sometimes has limitations and even second damages.We report a rare case of severe intrauterine adhesion caused by uterine perforation with a fallopian tube incarceration.A 24-year-old woman underwent severe intrauterine adhesion and secondary infertility caused by fallopian tube incaceration into the uterine cavity after postpartum curettage.First hysteroscopy created a false passage through the previous uterine perforation,entered into the cavity of incarcerated fallopian tube,and led to iatrogenic hydrosalpinx.Secondary hysteroscopy combined with laparoscopy revealed a connection between the right tubal lumen and the uterine cavity by the false passage,released the adhesion,and reconstructed the uterine cavity.Early recognition of uterine perforation or tissue incarcerarion is significant in preventing further damage.

Report and clinical study of one case of fallopian tube carcinosarcoma

This paper reports one case of fallopian tube carcinosarcoma for analyzing the diagnosis,treatment and prognosis.A perimenopausal 47-year-old patient with stage IA fallopian tube carcinosarcoma is reported.The diagnosis is usually made at the time of laparotomy for a pelvic or adnexal mass or other gynecological indication.As management of ovarian neoplasms,the mainstay of treatment is represented by debulking surgery consisting of total abdominal hysterectomy,bilateral salpingo-oophorectomy,random biopsies,peritoneal washing and excision of all the abdominal tumor masses.Although the prognosis of fallopian tube carcinosarcoma is poor,adjuvant chemotherapy may improve survival rate.This patient survived through surgery and chemotherapy. In brief,primary fallopian tube carcinosarcoma is rare.The pathologic examination is the basic for diagnosis, and the treatment of the carcinosarcoma includes surgery and chemotherapy.

An update on hormonal regulation of early embryo-fallopian tube interactions: insights for improvements of assisted reproductive technology outcomes

Human fallopian tubes(FTs)play important roles in the whole reproductive process.FTs are the site for the final maturation of gametes,fertilization,transport of preimplantation embryos,and early embryonic development before entering the uterus.All these functions are critical in the establishment of a successful pregnancy.When the embryo is in transit through the FT,the FT microenvironment changes through endocrine,paracrine,autocrine,and juxtacrine mechanisms which involve various hormones and bioactive substances mainly from the neighboring cells.Therefore,the interactions between the embryo and the FT may be the earliest embryo-maternal communications that are essential for the establishment of pregnancy.This review critically discusses the evidence of various hormonal and bioactive mediated control of the microenvironment in the FTs during the earliest embryo-maternal communications.Moreover,we highlight existing gaps in the knowledge and the importance of exploring more of the physiology of FTs which will hold the key to producing high-quality embryos for patients seekingin vitro fertilization(IVF)treatments.

腹腔镜下输卵管开窗取胚术配合甲氨蝶呤对输卵管妊娠患者宫内妊娠率的影响

目的探讨腹腔镜下输卵管开窗取胚术配合甲氨蝶呤治疗输卵管妊娠的效果。方法120例输卵管妊娠患者分为两组,对照组给予甲氨蝶呤治疗,实验组给予腹腔镜下输卵管开窗取胚术配合甲氨蝶呤治疗,比较两组的治疗效果。结果治疗后,实验组的总有效率高于对照组,月经恢复时间、包块消失时间、腹痛消失时间及住院时间均短于对照组,宫内妊娠率高于对照组(P<0.05)。结论腹腔镜下输卵管开窗取胚术配合甲氨蝶呤治疗输卵管妊娠患者可以提高宫内妊娠率,安全性高。

经阴道四维子宫输卵管超声造影检查用于不孕症诊断的准确性及评价输卵管通畅性价值研究

目的探讨经阴道四维子宫输卵管超声造影(4D-HyCoSy)检查用于不孕症诊断的准确性及评价输卵管通畅性价值研究。方法选取2019年6月~2022年6月我院疑似输卵管不孕症患者90例为研究对象,均行经阴道4D-HyCoSy检查,行腹腔镜输卵管通液术(LC)作为金标准。分析经阴道4D-HyCoSy对输卵管不孕的诊断效能及评价输卵管通畅性的价值。结果LC结果:90例疑似输卵管不孕患者共检查180条输卵管,左侧阻塞41条,非阻塞49条(其中通畅18条,通而不畅31条);右侧阻塞42条,非阻塞48条(其中通畅19条,通而不畅29条);经阴道4D-HyCoSy诊断左侧输卵管不孕的敏感性为80.49%(33/41),特异性为85.71%(42/49),准确性为83.33%(75/90),阳性预测值为82.50%(33/40),阴性预测值为84.00%(42/50);经阴道4D-HyCoSy诊断右侧输卵管不孕的敏感性为83.33%(35/42),特异性为89.58%(43/48),准确性为86.67%(78/90),阳性预测值为87.50%(35/40),阴性预测值为86.00%(43/50);经阴道4D-HyCoSy评价左侧输卵管通畅性的符合率为94.44%,Kappa指数=0.913;经阴道4D-HyCoSy评价右侧输卵管通畅性的符合率为93.33%,Kappa指数=0.894。结论经阴道4D-HyCoSy诊断输卵管不孕与具有较高的敏感性、特异性及准确性,且与LC结果评价输卵管通畅性的一致性较好。