title: Imaging in gynecological disease (9): clinical and ultrasound characteristics of tubal cancer.
abstract: OBJECTIVE
  To describe clinical history and ultrasound findings in patients with tubal carcinoma.
  
  
  METHODS
  Patients with a histological diagnosis of tubal cancer who had undergone preoperative ultrasound examination were identified from the databases of 13 ultrasound centers. The tumors were described by the principal investigator at each contributing center on the basis of ultrasound images, ultrasound reports and research protocols (when applicable) using the terms and definitions of the International Ovarian Tumor Analysis (IOTA) group. In addition, three authors reviewed together all available digital ultrasound images and described them using subjective evaluation of gray-scale and color Doppler ultrasound findings.
  
  
  RESULTS
  We identified 79 women with a histological diagnosis of primary tubal cancer, 70 of whom (89%) had serous carcinomas and 46 (58%) of whom presented at FIGO stage III. Forty-nine (62%) women were asymptomatic (incidental finding), whilst the remaining 30 complained of abdominal bloating or pain. Fifty-three (67%) tumors were described as solid at ultrasound examination, 14 (18%) as multilocular solid, 10 (13%) as unilocular solid and two (3%) as unilocular. No tumor was described as a multilocular mass. Most tumors (70/79, 89%) were moderately or very well vascularized on color or power Doppler ultrasound. Normal ovarian tissue was identified adjacent to the tumor in 51% (39/77) of cases. Three types of ultrasound appearance were identified as being typical of tubal carcinoma using pattern recognition: a sausage-shaped cystic structure with solid tissue protruding into it like a papillary projection (11/62, 18%); a sausage-shaped cystic structure with a large solid component filling part of the cyst cavity (13/62, 21%); an ovoid or oblong completely solid mass (36/62, 58%).
  
  
  CONCLUSIONS
  A well vascularized ovoid or sausage-shaped structure, either completely solid or with large solid component(s) in the pelvis, should raise the suspicion of tubal cancer, especially if normal ovarian tissue is seen adjacent to it.
authors.affiliation: Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Ludovisi
authors.forename: I
authors.initials: I
authors.lastname: De Blasis
authors.forename: B
authors.initials: B
authors.lastname: Virgilio
authors.forename: D
authors.initials: D
authors.lastname: Fischerova
authors.forename: D
authors.initials: D
authors.lastname: Franchi
authors.forename: M A
authors.initials: MA
authors.lastname: Pascual
authors.forename: L
authors.initials: L
authors.lastname: Savelli
authors.forename: E
authors.initials: E
authors.lastname: Epstein
authors.forename: C
authors.initials: C
authors.lastname: Van Holsbeke
authors.forename: S
authors.initials: S
authors.lastname: Guerriero
authors.forename: A
authors.initials: A
authors.lastname: Czekierdowski
authors.forename: G
authors.initials: G
authors.lastname: Zannoni
authors.forename: G
authors.initials: G
authors.lastname: Scambia
authors.forename: D
authors.initials: D
authors.lastname: Jurkovic
authors.forename: A
authors.initials: A
authors.lastname: Rossi
authors.forename: D
authors.initials: D
authors.lastname: Timmerman
authors.forename: L
authors.initials: L
authors.lastname: Valentin
authors.forename: A C
authors.initials: AC
authors.lastname: Testa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005185:Fallopian Tube Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D005187:Fallopian Tubes / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D005831:Genital Diseases, Female / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D018615:Ultrasonography, Doppler, Color
keywords: pattern recognition; retrospective study; tubal cancer; ultrasound