Primary fallopian tube carcinoma

Primary fallopian tube carcinoma (PFTC) is an extremely rare malignancy that arises from the fallopian tube. They account for ~1 (0.2-1.1)% all gynecological malignancies (least common of all gynecological malignancies 3).

The estimated incidence is at ~3-4 per million women 3. It typically present in post menopausal females (peaks at 6th-7th decades).

Most patients are asymptomatic or tend to present with non specific or insiduous symptoms. The symptoms complex comprising of an intermittent profuse serosanguineous vaginal discharge, colicky lower abdomino-pelvic pain relieved by the vaginal discharge, and an adnexal mass can be present in ~15% of and is termed the Latzko triad 13-14

Most primary fallopian tube cancers arise from ampulla with endoluminal growth that leads to obstruction and distension of the fallopian tube (hydrosalpinx), which explains why the majority of these patients are rarely asymptomatic in contrast with those with ovarian cancer. 

Tumors can be bilateral in 20% of the cases, mainly in advanced disease. 

The pattern of growth can be nodular, papillary, infiltrative, or mass forming. 

Recognized histological types include:

The tumor usually originates in the ampulla of the Fallopian tube. Bilateral involvement can in been is ~20% of cases 1.

Serum CA-125 levels often elevated 6,8

Advanced tumors are difficult to differentiate from ovarian tumors on imaging. The presence of a hydrosalpinx can be a useful feature.

While being non specific, it may be sonographically identified as a complex cystic mass involving the fallopian tube with papillary projections 10-11

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While signal characteristics are not specific, they generally are as follows 1,3

  • T1
    • solid tumor portion is usually of low signal 
    • if there is an associated simple serous fluid containing hydrosalpinx this may be low signal 
    • if there is an associated simple hemorrhagic fluid containing hydrosalpinx this may be high signal 
  • T2
    • solid tumor component is often homogeneously or heterogeneously low or of intermediate signal  
    • if there is an associated simple serous fluid containing hydrosalpinx this may be of high signal
  • T1 C+ (Gd): solid portion often demonstrates enhancement 

See: staging of primary fallopian tube carcinoma 

Compared with ovarian carcinoma, fallopian tube cancer more tends to present at an earlier stage but has a worse prognosis, stage for stage 2. The reposted better overall survival therefore may be on the basis of earlier stage at presentation 4. Treatment generally consists of surgical debulking followed by chemotherapy.

For a mass involving the fallopian tube, differential considerations would be:

Article information

rID: 13588
System: Gynaecology
Tag: cases
Synonyms or Alternate Spellings:
  • Primary tubal carcinoma
  • Tubal carcinoma
  • Fallopian tube carcinoma
  • Fallopian tubal carcinoma
  • Primary fallopian tube carcinoma (PFTC)
  • Primary carcinoma of the fallopian tube
  • Primary fallopian tubal carcinoma

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Cases and figures

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