[Fallopian tube primary invasive adenocarcinoma associated with acute inflammatory pelvic disease. Case report and literature review].
The primary fallopian tube invader adenocarcinoma is a preoperative diagnosis rarely reported in the literature, because is the most uncommon of all gynecological tumors, with prevalence from 0.3 to 1.8%. Since its clinical evolution is very unspecific, in general this tumor is diagnosed during a laparothomy for other purpose or by the pathologist in the final histopathological report. The most frequent signs and symptoms are abdominal pain or a pelvic mass in 80% of cases; transvaginal bleeding in 50%, intense transvaginal serohematic discharge (hidrops tubae profluens) in 11.1%, and peritonitis in pelvis in 3.7%. In 25 to 60% of the cases a report of adenocarcinoma in the pap smear with negative endometrial biopsy can be found. The treatment is predominantly surgical, as that of epithelial ovarian carcinoma, and consists of an intraperitoneal washing, total abdominal hysterectomy with bilateral salpingo-oophorectomy and a proper staging. It is required an omentectomy with pelvic and paraaortic lymphadenectomy in systematic way. In the more advanced stages III and IV that required a radical debulking, we have to be very emphatic in citoreduction. In some cases, as the persistence or recurrence of illness, it can be necessary adjuvant chemotherapy. In some patients in early stage I or II with low risk, the complete staging could not be necessary. There is controversy about administration criteria of adjuvant treatment, since there is not evidence of survival increase related to its use. The five years survival rate was 64% for stage I, 42% for stage II, 32% for stage III, and 17% for stage IV. Fallopian tube malignancies are rare and involve a poor prognosis.
Monge
Alejandro Hernández
AH
Subdireccion de Ginecologia y Obstetricia, Hospital General Dr. Manuel Gea González, Toriello Guerra, CP, México.
Pineda
Ruth Pacheco
RP
del Rocio Estrada Hernandez
María
M
Juárez
Evelyn García
EG
García
Julio César Polanco
JC
D000006:Abdomen, Acute / Q000209:etiology; D058186:Acute Kidney Injury / Q000209:etiology; D000230:Adenocarcinoma / Q000453:epidemiology / Q000235:genetics* / Q000601:surgery; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001002:Anuria / Q000209:etiology; D002443:Ceftriaxone / Q000627:therapeutic use; D002981:Clindamycin / Q000627:therapeutic use; D005185:Fallopian Tube Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D010052:Ovariectomy; D000292:Pelvic Inflammatory Disease / Q000150:complications* / Q000188:drug therapy; D010538:Peritonitis / Q000188:drug therapy / Q000209:etiology
D000900:Anti-Bacterial Agents; D002981:Clindamycin; D002443:Ceftriaxone