Primary Fallopian Tube Carcinoma Presenting Like a Primary Gastrointestinal Mass: Case Report

Desaree M. Ayson, M.D. and Mark Q. Antonio, M.D., FPOGS, FSGOP

Department of Obstetrics and Gynecology, Angeles University Foundation Medical Center, Pampanga, Philippines

 

Objective:

Primary fallopian tube carcinoma is a rare gynecologic malignancy, comprising approximately 0.14-1.8% of gynecologic malignancies. Preoperative diagnosis is challenging because of its non-specific symptomatology, which in this case presented as a primary gastrointestinal pathology.

Case study:

We report a case of primary fallopian tube carcinoma (PFTC) in a 50-year-old, G3P3 (3003), menopausal woman who presented with right upper quadrant pain clinically suggesting a primary gastrointestinal pathology. However, on further work-up and evaluation, an ovarian pathology was considered and consequently underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy with complete surgical staging and right hemicolectomy. The final histopathologic result showed poorly differentiated adenocarcinoma of the fallopian tube. Adjuvant chemotherapy with Carboplatin and Paclitaxel was given.

Discussion:

Due to the rarity of this tumor, histopathologic diagnosis and pre-operative surgical planning are important, in terms of proper diagnosis, treatment, and prognosis. Treatment of primary fallopian tube carcinoma is still patterned with that of ovarian epithelial carcinoma and prognosis remained poor, especially for advanced stages.

Conclusion:

This case report describes the complexity of diagnosing primary fallopian tube carcinoma preoperatively, which in this case presented as a primary gastrointestinal pathology hence, it is valuable to include primary fallopian tube carcinoma in the differential diagnosis of patients who present with a gastrointestinal mass and adnexal mass specifically with risk factors for PFTC such as inherited BRCA mutations and those with history of hereditary breast carcinoma and ovarian syndromes. In most cases, diagnosing PFTC is through histopathology and the treatment for PFTC is usually similar with ovarian carcinoma but treatment modalities may differ based on the staging of the disease at the time of diagnosis.