A 55‑year‑old, Gravida 2 Para 2 (2002), presented with postmenopausal vaginal bleeding. Workups pointed toward ovarian malignancy with distant metastasis (pleural effusion). Exploratory laparotomy, bilateral salpingo‑oophorectomy, surgical staging, and appendectomy were performed. On histopathological examination, synchronous high‑grade serous carcinoma of the right fallopian tube and borderline mucinous tumor of the left ovary were diagnosed. Primary fallopian tube carcinomas are very uncommon, while synchronous tumors of the female genital tract are extremely rare. Furthermore, there is a paucity of literature discussing the occurrence of synchronous primary malignancies arising from the fallopian tube and the ovary. It is crucial to differentiate primary malignancies from metastatic cancers to determine accurate staging and prognosis, as well as to assign appropriate treatment strategies. Immunohistochemistry and molecular testing play vital roles as adjunctive diagnostic tools to histologic examination in determining the origins of these tumors and distinguishing primary tumors from metastasis.
Fallopian Tubes ; Fallopian Tube Neoplasms ; Neoplasms, Cystic, Mucinous, and Serous

OBJECTIVE: To investigate the relationship between the precursors of high grade serous ovarian cancer (HGSOC) and the characteristics of patients with a low HGSOC risk in terms of the effects of pregnancy. METHODS: We prospectively examined consecutive cases in which the bilateral fallopian tubes were removed during benign gynecological or obstetric surgery and assessed the relationship between the patient characteristics, including parity and pregnancy, and the incidence of HGSOC precursors. All the fallopian tubes were examined by applying the Sectioning and Extensively Examining the Fimbriated End (SEE-FIM) Protocol. RESULTS: Of the 113 patients enrolled, 67 were gynecological and 46 were obstetric. The p53 signature was identified in 21 patients. No other precursors were identified. In a comparison of the p53 signature-positive and negative groups, parous women and pregnant women were significantly fewer in the p53 signature-positive group (53% vs. 86%, p=0.002, 10% vs. 47%, p=0.001, respectively). Current pregnancy was also associated with a significantly lower incidence of the p53 signature after multivariate adjustment (odds ratio [OR]=0.112; 95% confidence interval [95% CI]=0.017–0.731; p=0.022). Among gynecological patients, parous women were fewer in the p53 signature-positive group on univariate (47% vs. 73%, p=0.047) and multivariate analysis (OR=0.252; 95% CI=0.069–0.911; p=0.036). No other characteristics were associated with p53 signature positivity. CONCLUSIONS: The incidence of the p53 signature was significantly lower in parous women and pregnant women. This decreased incidence of early phase serous carcinogenesis may be one of the possible mechanisms underlying HGSOC risk reduction among parous women.
Carcinogenesis ; Cystadenocarcinoma, Serous ; Fallopian Tube Neoplasms ; Fallopian Tubes ; Female ; Humans ; Incidence ; Multivariate Analysis ; Obstetric Surgical Procedures ; Ovarian Neoplasms ; Parity ; Pregnancy ; Pregnant Women ; Prospective Studies ; Risk Reduction Behavior ; Tumor Suppressor Protein p53

OBJECTIVE: The aim of the present study was to assess the frequency of germline mutations in patients with peritoneal carcinoma (PC) or the fallopian tube carcinoma (FTC), using a multi-gene panel. METHODS: Twenty-six patients diagnosed with either PC or FTC between January 2013 and December 2016 were recruited consecutively. Germline DNA was sequenced using a 6-gene next generation sequencing (NGS) panel following genetic counseling. Surgico-medical information was obtained from hospital records. Genetic variations were detected using the panel and were cross-validated by Sanger direct sequencing. RESULTS: Germline BRCA1/2 mutations were identified in 6 patients (23.1%). Four were detected in patients with PC and 2 were in FTC patients. No mutations were detected in TP53, PTEN, CDH1, or PALB2. We identified 11 variant of uncertain significance (VUS) in 9 patients; 2 in BRCA1, 3 in BRCA2, 2 in TP53, and 4 in CDH1. We also detected a CDH1 c.2164+16->A VUS in 3 patients. CONCLUSION: The prevalence of germline BRCA1/2 mutations in patients with PC or FTC is comparable to that of BRCA1/2 mutations in epithelial ovarian cancer patients.
DNA ; Fallopian Tube Neoplasms ; Fallopian Tubes* ; Female ; Genes, BRCA1 ; Genes, BRCA2 ; Genetic Counseling ; Genetic Variation ; Germ-Line Mutation ; Hospital Records ; Humans ; Ovarian Neoplasms ; Peritoneal Neoplasms ; Peritoneum* ; Prevalence*

Mullerianosis is a rare, benign, and morphologically complex, tumor-like lesion that consists of an organoid structure with normal Müllerian tissue. The diagnosis requires the presence of at least two of the three mullerian tissues: endometriosis, endosalpingiosis, and endocervicosis. There are only less than twenty (20) cases reported in literature. At present there is no published case report of mullerianosis here in the Philippines. This is a case report of a 30-year old Filipino woman who presented predominantly with lower urinary tract symptoms of severe dysuria, hematuria, and lumbar pain and was evaluated for a urologic problem secondary to a posterior bladder mass. Subsequent evaluations revealed the diagnosis of mullerianosis. This is where the interest in mullerianosis sets, its potential to mimic a neoplastic lesion of the urinary tract from clinical and diagnostic viewpoints. The clinical importance to diagnose this case correctly is of grave importance for appropriate management.

Human ; Female ; Dysuria ; Endometriosis ; Fallopian Tube Diseases ; Hematuria ; Lower Urinary Tract Symptoms ; Neoplasms ; Organoids ; Pain ; Philippines ; Urinary Bladder Diseases

OBJECTIVE: Bevacizumab was recently approved by the US Food and Drug Administration for use in recurrent platinum resistant epithelial ovarian cancer (EOC), fallopian tube cancer (FTC), or primary peritoneal cancer (PPC) when no more than two prior cytotoxic regimens have been used; due to concerns for gastrointestinal perforation. We sought to determine bevacizumab-related toxicities in heavily pretreated recurrent EOC. METHODS: We performed a retrospective chart review of patients with recurrent EOC, FTC, and PPC from 2001 to 2011. Patients who received at least two prior chemotherapy regimens before bevacizumab were included. Medical records were reviewed for bevacizumab associated toxicities. The Wilcoxon-Mann-Whitney test was used to compare quantitative variables. Survival was estimated with the Kaplan-Meier method. RESULTS: Sixty patients met inclusion criteria. At the start of bevacizumab treatment, the median age was 60 years and the median body mass index was 26.5 kg/m². More than 50% of patients received bevacizumab after three prior cytotoxic regimens. Grade 3 or higher bevacizumab associated toxicity events occurred in four patients, including one patient who developed a rectovaginal fistula. The median overall survival from the start of bevacizumab treatment was 21.05 months (95% CI, 18.23 to 32.67; range, 1.9 to 110 months). The number of cytotoxic regimens prior to bevacizumab treatment did not differ in those that experienced a toxicity versus those that did not (p=0.66). CONCLUSION: The use of bevacizumab in heavily pretreated EOC, FTC, or PPC is worth consideration.
Adult ; Aged ; Aged, 80 and over ; Angiogenesis Inhibitors/*therapeutic use ; Bevacizumab/*adverse effects ; Fallopian Tube Neoplasms/*drug therapy ; Female ; Humans ; Intestinal Perforation/chemically induced ; Middle Aged ; Neoplasm Recurrence, Local/*drug therapy ; Neoplasms, Glandular and Epithelial/*drug therapy ; Ovarian Neoplasms/*drug therapy ; Peritoneal Neoplasms/*drug therapy ; Retrospective Studies

No abstract available.
Fallopian Tube Neoplasms/*genetics ; Female ; Genes, BRCA1 ; Genes, BRCA2 ; *Genetic Testing ; Humans ; Mutation ; Ovarian Neoplasms/*genetics ; Peritoneal Neoplasms/*genetics ; Republic of Korea ; Societies, Medical

No abstract available.
Fallopian Tube Neoplasms/*genetics ; Female ; Genes, BRCA1 ; Genes, BRCA2 ; *Genetic Testing ; Humans ; Mutation ; Ovarian Neoplasms/*genetics ; Peritoneal Neoplasms/*genetics ; Republic of Korea ; Societies, Medical

No abstract available.
Carcinoma in Situ/*pathology ; Fallopian Tube Neoplasms/*pathology ; Female ; Humans ; Neoplasm Staging ; Ovarian Neoplasms/*pathology

No abstract available.
Fallopian Tube Neoplasms/classification/*pathology ; Female ; Gynecology/organization & administration/standards ; Humans ; International Agencies ; Neoplasm Staging/methods/*standards ; Obstetrics/organization & administration/standards ; Ovarian Neoplasms/classification/*pathology ; Peritoneal Neoplasms/classification/*pathology ; *Practice Guidelines as Topic

Primary fallopian tube carcinoma (PFTC) is a rare gynecological cancer that is very difficult to diagnose preoperatively. Here, we report the case of a 66-year-old female patient with PFTC that was diagnosed preoperatively on the basis of the characteristic features on endoscopic ultrasound (EUS) elastography and fine needle biopsy (FNB). EUS showed a sausage-shaped hypoechoic mass, 8 cm in size, with irregular margins and heterogeneous internal echoes extending to both adnexa. EUS elastography revealed that the mass had a blue color pattern, representing hard stiffness, and a heterogeneous green/red color pattern distributed outside the tumor, representing intermediate stiffness. Histopathologic analysis of the FNB and operative specimens confirmed the diagnosis of fallopian tube carcinoma. This is the first reported case of a combined EUS elastography and FNB of an adnexal mass leading to a preoperative diagnosis of fallopian tube carcinoma.
Aged ; Biopsy, Fine-Needle* ; Diagnosis ; Elasticity Imaging Techniques* ; Endosonography ; Fallopian Tube Neoplasms ; Fallopian Tubes* ; Female ; Humans ; Ultrasonography*