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1099 Case report: 55-year-old patient with a fallopian tube wolffian tumor (female adnexal tumor of wolffian orirgin)
  1. A Digeni,
  2. AA Avgoustidis and
  3. S Schiermeier
  1. Marienhospital Witten, Gynecology and Obstetrics, Witten, Germany


Introduction/Background*The Wolffian tumor is a rare, usually benign tumor first described in 1973 as a ‘female adnexal tumor of probable Wolffian origin (FATWO)’’. There have been less than 100 cases reported in the literature, with fewer than 30 cases of malignant or recurrent disease.1,2 These tumors are solid or cystic and characterised by small, closely packed cells like a ‘sieve-like’ patern.3-6 The majority of tumors occur within the broad ligament, fallopian tubes, mesosalpinx, or ovary.7 In the following report we describe the case of FATWO of the fallopian tube, discovered in a 55-year-old female undergoing laparoscopic bilateral salpingo-oophorectomy.

Methodology A 55-year-old asymptomatic, postmenopausal patient was referred to our hospital with an adnexal mass for evaluation. Pelvic transvaginal ultrasound revealed a uterus myomatosus and a 8 x 4 cm partially cystic, solid mass in the pouch of Douglas. The colour Doppler examination was negative. Serum tumor markers were negative (CEA, CA-125). The patient was prepared for a laparoscopic bilateral salpingo-oophorectomy which was successfully performed. Intraoperatively, an approx. 6.5x4 cm twisted, round, solid-cystic structure with an irregular surface was discovered on the right fallopian tube. The mass was excised laparoscopically with both of adnexa using electrocautery. The postoperative phase was uneventful. The histology initially described an undifferentiated tumor which was shown by immunohistochemistry analysis to be a Wolffian tumor.

Result(s)*After negative staging with abdomen and thorax CT, the case was presented to the hospital’s tumor board where treatments were discussed and a total laparoscopic hysterectomy was indicated. The patient underwent a total laparoscopic hysterectomy and abdominal biopsies with negative histology.

The rarity of the disease has led to poorly-defined therapeutic options. It has been considered that the most effective therapy is complete surgical resection with hysterectomy and bilateral adnexectomy.8,9 Sole tumor resection is a risk factor for relapse. The role of adjuvant chemotherapy or radiation is controversial.8

Conclusion*Due to rarity of cases and data concerning the malignant progression of such tumors, more studies are required to decide upon the appropriate management. Although some cases are benign, there has been evidence of malignant behavior. The efficacy of adjuvant therapy is still in question. Following surgical treatment, regular follow-up examinations should be planned for the long-term.

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