Fallopian tube cancer is defined as that which starts within the fallopian tubes, a pair of ducts that transport eggs from ovary to uterus. Primary carcinoma of the fallopian tube is very rare, comprising only 1-2% of all gynecologic cancers. Less than 1500 cases have been reported worldwide, and as many as 90% of tubal cancers are metastatic from other sites. Since the disease is so uncommon, little is known about its causes and/or risk factors, and treatment approaches have been taken from experiences with ovarian cancer. Adenocarcinomas are the most commonly found cell-types, but leiomyosarcomas and transitional cell carcinomas are reported. Unlike ovarian cancer, grade of the histology appears to have little significance in overall survival.
Symptoms of fallopian cancer might include vaginal bleeding, discharge, abdominal discomfort and feelings of pressure. Colicky abdominal pain that is relieved by a passage of blood or a watery discharge may be an indicator of fallopian tube cancer, especially if a palpable mass is felt during pelvic examination. Fallopian cancer is usually diagnosed after surgical exploration. It is distinguishable from ovarian cancer when its origin can be clearly demonstrated. To do this, the pathologist looks for an area of the epithelium that shows a continuous transition from normal to malignant cells, proving that the cancer arose within the fallopian tube.
Fallopian tube cancer is staged according to FIGO standards by the surgical pathologic system based on operative findings. The Stages are:
Stage 0 Carcinoma in situ
Stage I Growth limited to fallopian tubes
Stage II Growth involving one or both fallopian tubes with extension to pelvis
Stage III Tumor involving one or both fallopian tubes with spread outside pelvis
Stage IV Growth involving one or more fallopian tubes with distant metastases
Aggressive surgery, consisting of total hysterectomy, bilateral salpingo-oophorectomy, partial omentectomy, pelvic and para-aortic node sampling, and peritoneal cytology is performed to treat and stage fallopian tube cancer. For patients in advanced stages, further treatment with chemotherapy and radiation may be indicated.