Fallopian Tube Adenocarcinoma: a Report of Two Cases

Abstract

Primary malignant tumors in the fallopian tube are the least common in the female gynecologic apparatus, corresponding from 0.1 to 0.5% of the total of such tumors. The incidence peak is around 60 years. Very rigorous criteria must be applied in order to consider a primary neoplastic injury of the tube, because the closeness to both endometrial mucosa and ovary complicates the diagnosis. The first case is a 44-year-old female patient who underwent laparotomy for presenting a pelvic tumor. The right fallopian tube was identified with an injury and total hysterectomy with right salpingectomy and left oophorectomy, preserving the right ovary, were performed. The histopathological study showed a little differentiated adenocarcinoma in the right fallopian tube, as well as the presence of two metastatic focuses in the left ovary. Adjuvant chemotherapy was initiated. After six cycles, injuries in both pelvic and para-aortic were noticed, as well as injury of the vaginal cupola. The patient underwent a right oophorectomy and pelvic and para-aortic lymphadenectomy. The histopathological study of specimens did not show any neoplasm. The second case is a 63-year-old female patient with a cystic injury in the left uterine annex and a mixed injury in the right annex. A bilateral salpingo-oophorectomy was performed. The histopathological study showed a moderately differentiated adenocarcinoma in the right fallopian tube. After this diagnosis, hysterectomy and omentectomy were both performed and did not present neoplastic disease in the histopathology. Both patients are healthy and with no evidence of neoplastic disease in activity, 40 and 72 months after the first surgery, respectively.