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Abstract
Introduction/Background Fallopian tube carcinoma is rare, accounting for approximately 0.2% of cancers among women. It has been suggested that many cases of ovarian carcinoma may actually arise from the epithelial lining of the fallopian tube fimbria, thereby grossly under-estimating the incidence of primary fallopian tube carcinoma. We report a 63-year old, nulligravid patient presenting with abdominal enlargement. Based on history and physical examination, clinical impression was ovarian new growth probably malignant. Official transabdominal ultrasound revealed a large abdominopelvic mass considered ovarian new growth probably borderline malignant.
Methodology Surgical plan was total abdominal hysterectomy with bilateral salpingo oophorectomy, with or without bilateral pelvic lymph node dissection, paraaortic lymph node sampling, infracolic omentectomy, random peritoneal biopsy, with or without appendectomy.
Results Intraoperatively, pathologies identified were the right fallopian tube and bilateral ovaries. Intraoperative staging followed since the specimens were suspicious for malignancy. She was diagnosed with Ovarian new growth, bilateral, malignant, intraoperative stage IIA, cannot totally rule out primary fallopian tube malignancy, right.
Official histopathology result revealed a high grade serous carcinoma arising from the serous tubal intraepithelial carcinoma of the right fallopian tube, involving both ovaries. Final diagnosis was Serous tubal intraepithelial carcinoma, right fallopian tube, stage IIA. On follow up, patient was counseled on the appropriate management for STIC which involves adjuvant chemotherapy.
Conclusion Clinical diagnosis of primary fallopian tube carcinoma is technically challenging because of its similarities with the clinical presentation of an ovarian malignancy. Surgery and histopathology remains to be the definitive tool in determining a primary fallopian tube carcinoma. There is still no clear guideline in the management of post surgical STIC as its management has been similar with cancers of the ovary and peritoneum. Appropriate management, follow up, and surveillance of patients diagnosed with STIC should be practiced by clinicians and to involve high-risk family members in counseling.
Disclosures None