Cancer of the fallopian tube – the rarest malignant tumor of the female genital organs, the frequency of which is 0.11 – 1.18%. Cancer of the fallopian tube is more often detected at the age of 50-52 years. As a rule, the tumor affects one fallopian tube. A history of patients often have infertility and lack of childbirth.
Cancer in the fallopian tube may occur primary (primary cancer), but much more often develops secondary, due to the spread of cancer from the body of the uterus, ovary (secondary cancer). There are metastases of breast cancer and tumors of the gastrointestinal tract (metastatic cancer).
According to the morphological structure, primary cancer of the uterine tube can be papillary, papillary-glandular, glandular-solid.
Primary cancer of the fallopian tube is distributed, as well as ovarian cancer, lymphogenous, hematogenous and implantation, with metastases in the inguinal and para-aortic lymph nodes.
There are 4 stages of primary cancer of the fallopian tube:
Stage I – cancer is limited to the fallopian tube;
Stage II – cancer is limited to one or two tubes and spreads to
the limits of the pelvis (uterus, ovaries, fiber);
Stage III – a tumor affects one or two fallopian tubes, small organs
pelvis (uterus, ovaries), there are metastases in paraaortalny and inguinal
The lymph nodes;
Stage IV – a tumor affects one or two fallopian tubes, small organs
pelvis, there are metastases in paraaortal and inguinal lymph nodes,
The stage of cancer is determined by a laparotomy process.
Clinical symptoms and diagnosis of uterine tube cancer. Unlike ovarian tumors, including malignant, uterine tube cancer has clinical manifestations in its early stages. Since the fallopian tube communicates anatomically with the uterine cavity through the uterine opening of the tube, blood and tumor decay products enter the uterine cavity and then through the cervical canal into the vagina, manifesting as pathological secretions. The main clinical manifestation of uterine tube cancer is abnormal discharge from the genital tract: serous, serous-purulent, often serous-bloody, less often the color of meat slop. The amount of discharge can be different, from bloody to profuse. The duration of the discharge to establish the diagnosis is on average 6-12 months.
The second most common symptom in cancer of the fallopian tube is pain in the lower parts of the flesh, especially on the side of the diseased tube.
Most often for cancer of the fallopian tube in the small pelvis to the left or right of the uterus, a volume formation with a diameter of 3 cm or more is palpated. When cancer of the fallopian tube is sometimes detected ascites. In some cases, the disease is asymptomatic.
The correct diagnosis for primary cancer of the fallopian tubes before the operation is rarely established (in 1-13% of cases). Differential diagnosis is carried out with ovarian tumor, uterine cancer, uterine myoma, inflammatory process in the pelvis.
Cancer of the fallopian tube should be considered when women older than 40 years old, especially in the postmenopausal period, begin to rapidly increase the uterine appendages with no indication of an acute inflammatory process of the internal genital organs. The diagnosis becomes more likely if an increase in the uterine appendages is accompanied by a decrease in the number of leukocytes, an increase in ESR at normal body temperature.
In secondary cancer of the fallopian tube, the clinical picture is determined by the underlying disease (cancer of the uterus, ovaries).
In order to diagnose cancer of the fallopian tube, cytological examination of the aspirate from the uterus, the cervical canal is recommended. To improve the accuracy of cytological examination, discharge is collected using special caps or tampons, which are inserted into the vagina for several hours.
For the diagnosis of cancer of the fallopian tube using ultrasound with DCT. The ultrasound method allows to detect a tube tumor even in obese patients. Abnormal blood flow in the tumor formation indicates a malignant process. The value of the technique is significantly increased by comparing the results with cytological examination of aspirates from the uterus and vaginal discharge.
Diagnosis of uterine tube cancer even during surgery (laparoscopy, laparotomy) can be made only in every second patient.
In the early stages of the disease, the tube looks intact and the tumor can be skipped if the integrity of the fallopian tube is not compromised. In later stages, the fallopian tube acquires the form of a sacculate sausage-shaped, pear-shaped or retort-shaped tumor, resembling pyosalpinx in appearance. Most often, the tumor is localized in the ampullary section of the fallopian tube. In the incision, the affected pipe is a cavity filled with masses that look like cauliflower.