fallopian tube papillary adenocarcinoma

Fallopian Tube Papillary Adenocarcinoma: A Rare and Aggressive Form of Cancer

Fallopian tube papillary adenocarcinoma is a rare and aggressive form of cancer that affects the fallopian tubes, which are two narrow tubes that connect the ovaries to the uterus. This type of cancer is characterized by its papillary structures, which are finger-like projections of tissue that grow into the surrounding area.

Types and Characteristics

• Papillary serous adenocarcinomas: More than 95% of fallopian tube cancers are papillary serous adenocarcinomas, which means they form on the tissue that lines or covers the fallopian tubes.
• High-grade serous tumors: Most fallopian tube and ovarian tumors are high-grade serous tumors, which means they spread fast.
• Aggressive behavior: Fallopian tube papillary adenocarcinoma is known to be an aggressive form of cancer that can quickly spread to other parts of the body.

Symptoms and Diagnosis

• Vaginal mass: This type of cancer can present as a vaginal mass, which is a lump or growth in the vagina.
• Abdominal pain: Patients may experience abdominal pain, bloating, or discomfort due to the tumor's growth.
• CA 125 marker: The CA 125 tumor marker can be elevated in patients with fallopian tube carcinoma.

Prognosis and Treatment

• Stage of disease: The stage of the disease at laparotomy (surgical exploration) is the most important prognostic factor for fallopian tube carcinoma.
• Surgery: Surgical removal of the tumor, along with chemotherapy and/or radiation therapy, may be necessary to treat this type of cancer.

References

• [1] by E Kadour-Peero · 2018 · Cited by 8 — This is the first report to describe primary fallopian tube papillary serous carcinoma presenting as a vaginal mass.
• [2-4] Recent evidence has begun to accumulate that indicates that many cases of high-grade serous papillary carcinoma arise from the fallopian tubes rather than the ovaries.
• [5] More than 95% of fallopian tube cancers are papillary serous adenocarcinomas, which means they form on the tissue that lines or covers the fallopian tubes.

Common Signs and Symptoms

Fallopian tube papillary adenocarcinoma, a type of cancer that affects the fallopian tubes, can exhibit various symptoms. While these may be similar to those experienced in other conditions, it's essential to note them for early detection and treatment.

• Abnormal vaginal bleeding: This is one of the most common symptoms, particularly in postmenopausal women [1].
• Pelvic or abdominal pain: Pain in the pelvic area can be a symptom, which may worsen over time [2].
• A palpable mass in the pelvic area: A noticeable lump or mass in the pelvis can indicate the presence of cancer [4].

Other Possible Symptoms

While not as common, other symptoms that may occur include:

• Vaginal discharge: Clear or serosanguinous vaginal discharge can be a symptom [6].
• Colicky pain: Painful cramps in the lower abdomen can be experienced by some patients [5].

Importance of Early Detection

It's crucial to note that early-stage fallopian tube cancer may not exhibit any symptoms. However, when symptoms do appear, they are often nonspecific and can be mistaken for other conditions.

• Vague symptoms: Symptoms like indigestion and bloating can be indicative of ovarian cancer, which shares some similarities with fallopian tube cancer [7].
• Abdominal mass: A palpable abdominal mass may indicate the presence of cancer [9].

References

[1] Context 1: Patients with fallopian tube cancer may have symptoms that include irregular vaginal bleeding or discharge...

[2] Context 2: Presenting symptoms of fallopian tube carcinoma are vague, but may include abdominal bloating, fullness, difficulty eating, bowel or bladder changes, pelvic or ...

[3] Context 3: More than 95 percent of fallopian tube cancers are papillary serous adenocarcinomas.

[4] Context 4: Jan 30, 2024 — Symptoms · Abnormal vaginal bleeding, particularly in postmenopausal women. · Pelvic or abdominal pain. · A palpable mass in the pelvic area.

[5] Context 5: Fallopian tube carcinoma characteristically demonstrates hydrosalpinx with a solid mural nodule or mass in a patient with colicky pain, vaginal bleeding, and a ...

[6] Context 6: by R Dhakhwa · 2020 · Cited by 1 — The classic signs and symptoms of tubal carcinoma include vaginal bleeding, clear of serosanguinous vaginal discharge, pelvic pain and a pelvic mass.

[7] Context 7: Aug 23, 2020 — The symptoms of ovarian cancer are typically vague (such as indigestion and bloating) and early-stage ovarian cancer has no symptoms.

[8] Context 8: Jul 27, 2021 — Once they do appear, signs and symptoms of ovarian cancer can include the following: Bloating; Pelvic or abdominal pain; Difficulty eating or ...

[9] Context 9: Aug 15, 2024 — Signs and symptoms. Early ovarian cancer causes minimal, nonspecific, or no symptoms. The patient may feel an abdominal mass. Most cases are ...

Diagnostic Tests for Fallopian Tube Papillary Adenocarcinoma

Fallopian tube papillary adenocarcinoma (PFTC) is a rare and aggressive type of cancer that affects the fallopian tubes. Diagnosing PFTC can be challenging, but various diagnostic tests can help identify this condition.

Imaging Studies

• Magnetic Resonance Imaging (MRI): Preoperative workups using MRI are capable of differentiating PFTC from epithelial ovarian carcinomas (EOCs) [1].
• Ultrasound: Transvaginal ultrasound, utilizing high-frequency probes, can help identify tumors and detect abnormalities in the pelvis and abdomen [3][5].
• Computed Tomography (CT): CT scans can be used to stage the disease and identify any metastasis [4].

Other Diagnostic Tests

• Cervical Smear: A routine screening measure for carcinoma of cervix, which can also be a practical tool for identifying PFTC [2].
• Blood Tests: While not specific to PFTC, blood tests may be used to rule out other conditions and monitor the disease progression.
• Histological Examination: The definitive diagnosis requires histological examination of tissue samples. Further imaging such as CT scan or PET-CT are necessary to stage the disease [8].

Additional Findings

• Studies have confirmed the presence of the same TP53 mutant in premalignant tubal lesions and PFTC, which can aid in diagnosis [7].
• The preoperative diagnosis of FTC was established by the presence of an adnexal mass with an incomplete septation on transvaginal sonography [9].

References:

[1] H Winarto (2017) - Preoperative workups using magnetic resonance imaging (MRI) are capable of differentiating PFTC from epithelial ovarian carcinomas (EOCs).

[2] UM Ural (2014) - Cervical smear, a routine screening measure for carcinoma of cervix, can be a practical and valuable tool for identifying PFTC.

[3] Additional testing may include imaging studies of the pelvis (and abdomen) via ultrasonography (US) or computed tomography (CT).

[4] Jan 30, 2024 - Diagnosis · Pelvic examination to detect any abnormalities. · Imaging tests such as ultrasound, CT scan, or MRI to identify tumours.

[5] D Zhan (2024) - The presence of intraluminal tubarian mass, sausage-like shape and visualization of normal ovaries can help to the correct diagnosis.

[6] MV Revzin (2020) - The imaging modalities used for the evaluation of fallopian tube disease and patency range from commonly used examinations such as US, CT, and MRI to other...

[7] M Stasenko (2019) - Several immunohistochemistry and targeted sequencing studies confirmed the presence of the same TP53 mutant in the premalignant tubal lesions as...

[8] The definitive diagnosis requires histological examination. Further imaging such as CT scan or PET-CT are necessary to stage the disease.

[9] N Haratz-Rubinstein (2004) - The preoperative diagnosis of FTC was established by the presence of an adnexal mass with an incomplete septation on transvaginal sonography.

Treatment Options for Fallopian Tube Papillary Adenocarcinoma

Fallopian tube papillary adenocarcinoma is a rare and aggressive form of cancer that affects the fallopian tubes. The treatment options for this type of cancer are similar to those for ovarian epithelial, fallopian tube, and primary peritoneal cancer.

• Surgery: Surgery is often the first line of treatment for fallopian tube papillary adenocarcinoma. This may involve a hysterectomy (removal of the uterus), bilateral salpingo-oophorectomy (removal of both ovaries and fallopian tubes), or other surgical procedures to remove the tumor.
• Chemotherapy: Chemotherapy is often used in conjunction with surgery to treat fallopian tube papillary adenocarcinoma. Common chemotherapy agents used for this type of cancer include carboplatin, paclitaxel, and cisplatin.
• Targeted Therapy: Targeted therapy, such as PARP inhibitors (e.g., olaparib), may also be used to treat fallopian tube papillary adenocarcinoma. These medications target specific molecules involved in cancer cell growth and survival.

Specific Treatment Options

According to recent studies [3], the mainstay of treatment for fallopian tube papillary adenocarcinoma is surgical cytoreduction, followed by platinum-based chemotherapy. The optimal timing for surgery and chemotherapy remains a topic of debate among medical professionals.

Some women with stage II ovarian cancer are treated with intraperitoneal (IP) chemotherapy, which involves delivering chemotherapy directly into the abdominal cavity [2]. This approach may be considered for patients with fallopian tube papillary adenocarcinoma as well.

Emerging Therapies

Research is ongoing to explore new and more effective treatment options for fallopian tube papillary adenocarcinoma. For example, studies have investigated the use of paclitaxel, topotecan, pegylated liposomal doxorubicin, docetaxel, and pemetrexed, with or without bevacizumab [10].

References

[1] Context result 3: Ovarian epithelial, fallopian tube, and primary peritoneal cancer treatments include surgery, chemotherapy, targeted therapy, and PARP inhibitors.

[2] Context result 2: Some women with stage II ovarian cancer are treated with intraperitoneal (IP) chemotherapy.

[3] Context result 3: The mainstay of treatment is surgical cytoreduction and platinum-based chemotherapy.

[4] Context result 9: After surgery, radiation, chemo, or both may be used. The chemo often includes the drug paclitaxel and carboplatin.

[5] Context result 10: Studies have explored the use of paclitaxel, topotecan, pegylated liposomal doxorubicin, docetaxel, and pemetrexed, with or without bevacizumab.