scholarly journals Primary High Grade Serous Carcinoma of the Fallopian Tube: A Case Report

2020 ◽  
Vol 58 (231) ◽  
Author(s):  
Ramesh Dhakhwa ◽  
Anshu Vaidya ◽  
Amrita Giri ◽  
Archana Shakya ◽  
Achala Vaidya
Keyword(s):  
Fallopian Tube ◽  
Lower Abdominal Pain ◽  
Abnormal Uterine Bleeding ◽  
Total Abdominal Hysterectomy ◽  
Figo Stage ◽  
Abdominal Hysterectomy ◽  
Serous Carcinoma ◽  
Ca 125 ◽  
High Grade ◽  
Anatomic Site

A 49-year-old, perimenopausal nulliparous woman with lower abdominal pain and abnormal uterine bleeding. Clinical and radiological findings suggested a right adnexal tumor. CA-125 level was moderately elevated. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was done. Peroperative findings revealed a soft to friable growth arising from right fallopian tube with no involvement of ovaries. Histopathologic examination confirmed it to be a high grade serous carcinoma, FIGO stage IA. The histomorphology resembled high grade serous carcinoma of ovary, however ovaries on both sides appeared unremarkable. Surgery was uneventful and the patient was discharged after seven days of hospital stay. She did not receive postoperative chemotherapy or radiotherapy and is under follow-up. The case is reported for its occurrence in an uncommon anatomic site and preoperative dilemma with relevant review of literature.

scholarly journals Screening and Prevention for High-Grade Serous Carcinoma of the Ovary Based on Carcinogenesis—Fallopian Tube- and Ovarian-Derived Tumors and Incessant Retrograde Bleeding

Diagnostics ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 120 ◽  
Author(s):  
Isao Otsuka ◽  
Takuto Matsuura
Keyword(s):  
Fallopian Tube ◽  
Ovarian Surface Epithelium ◽  
Serous Carcinoma ◽  
Ca 125 ◽  
Surface Epithelium ◽  
Screening Methods ◽  
High Grade ◽  
Endometrial Cavity ◽  
Screening And Prevention ◽  
Tumor Dna

High-grade serous carcinoma (HGSC) is the most common and lethal subtype of ovarian carcinoma. Many HGSCs are now believed to originate in the fallopian tube epithelium; ovarian surface epithelium is another possible origin. Thus, current screening methods, i.e., ultrasonography and serum CA-125 measurements, have a limitation in their early detection. Recently, circulating biomarkers, such as tumor DNA, autoantibody, and microRNA, have been investigated to detect HGSCs. As cancer cells in the fallopian tube flow into the endometrial cavity, the detection of exfoliated cells, tumor DNA, and proteome from samples obtained from the endometrial cavity or the cervix may be useful. The risk of ovarian serous carcinoma is affected by the use of oral contraceptive and menopausal hormone therapy (MHT). MHT regimens causing endometrial bleeding increase serous carcinoma risk, hence, incessant retrograde bleeding from the endometrial cavity into the Douglas pouch appears to play an important role in high-grade serous carcinogenesis. In this review, we provide an overview of current and novel screening methods and prevention approaches for ovarian and fallopian tube HGSC.

scholarly journals Loss of tubal ciliated cells as a risk for “ovarian” or pelvic serous carcinoma

2020 ◽  
Author(s):  
Yue Wang ◽  
Wanrun Lin ◽  
Yiying Wang ◽  
Yan Wang ◽  
Setsuko Chambers ◽  
...  
Keyword(s):  
High Risk ◽  
Fallopian Tube ◽  
Low Risk ◽  
Serous Carcinoma ◽  
Secretory Cells ◽  
High Grade ◽  
Ciliated Cells ◽  
Anatomic Site ◽  
Pelvic Serous Carcinoma

Abstract Background Recent advances suggest the fallopian tube as the main anatomic site for high-grade ovarian or pelvic serous carcinoma (O/PSC). Human fallopian tube is mainly lined by two cell types, secretory and ciliated cells. Large number of studies on the biologic role of tubal secretory cells in O/PSC have been performed in the last decade. However, the role of tubal ciliated cells in relation to the development of O/PSC has rarely been explored. The purpose of this study was to determine if change of the tubal ciliated cells shows difference in age and location and to examine their association with serous neoplasia. Methods Three groups (low-risk or benign control, high-risk, and O/PSC) of patients were age matched. The age data was stratified by 10-year intervals ranging from age 20 to older than 80. Ciliated cells from both tubal fimbria and ampulla segments were counted by microscopy and by tubulin immunohistochemical staining. The data was analyzed by standard contingency table, Poisson distribution methods, nonparametric Mann–Whitney U-tests and Spearman correlation analysis after age justification. Results The study revealed that the absolute number of tubal ciliated cells decreased significantly with age within each group. A reduction in ciliated cells within the fallopian tube remained a significant risk factor for serous neoplasia after age adjustment. A dramatic decrease of tubal ciliated cells in both tubal segments was identified in patients with high-risk and with O/PSC compared to those in the low-risk (benign control) group (p < 0.001). Further, within the fimbria segment, a reduced number of tubal ciliated cells was more prevalent in the high-risk group when compared to those in O/PSC group. Conclusion Our findings suggest that reduced number of ciliated cells within the fallopian tube represents a hallmark of early serous carcinogenesis. Findings also support a relationship between loss of tubal ciliated cells and aging, the presence of high-risk factors, and co-existing ovarian or pelvic high-grade serous cancers. This represents an early study identifying the role of tubal ciliated cells in the process of high-grade O/PSC development.

scholarly journals A Case Report of High-Grade Endometrial Stromal Sarcoma: A Rare Cause of Abnormal Uterine Bleeding in a Young Woman

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Nuntasiri Eamudomkarn ◽  
Yuwadee Itarat ◽  
Pilaiwan Kleebkaow ◽  
Chumnan Kietpeerakool
Keyword(s):  
Young Women ◽  
Endometrial Stromal Sarcoma ◽  
Abnormal Uterine Bleeding ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Pelvic Cavity ◽  
Rapid Progression ◽  
High Grade ◽  
Excessive Bleeding ◽  
Stromal Sarcoma

High-grade endometrial stromal sarcoma (HG-ESS) is a rare clinical entity, particularly among young women, and only few cases have been reported in the literature. Herein, we describe the case of a 21-year-old woman who presented with a four-month history of excessive bleeding per vagina. Endometrial curettage and cervical biopsy revealed a malignant round cell tumor suggestive of metastatic sarcoma of uterine origin. Computed tomography of the abdominopelvic region showed an enlarged uterus with diffused thickening throughout the entire endometrial cavity. Intraabdominal lymphadenopathy and ascites in the pelvic cavity were noted. The patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, resections of the enlarged pelvic nodes, omentectomy, and biopsy of the peritoneal nodules in the cul-de-sac. Histological examination revealed a tumor with a permeative growth pattern composed of uniformly high-grade round cells with brisk mitotic activity and extensive lymphovascular space invasion. Sections of the pelvic lymph nodes on both sides and the peritoneal nodule revealed multiple metastatic foci. Immunohistochemical studies showed positive diffuse staining for vimentin, CD 10, and cyclin D1. The pathological diagnosis was HG-ESS stage IIIC. The patient experienced rapid progression of the disease while receiving adjuvant treatment and succumbed eight months after the operation. HG-ESS is a rare cause of AUB in adolescents and young women but should be considered in the differential diagnosis.

scholarly journals An Unusual Presentation of Choriocarcinoma: A Case Report with a Long Latent Period

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Fateme Sadat Najib ◽  
Zahra Shiravani ◽  
Mojgan Hajisafari ◽  
Shaghayegh Moradi Alamdarloo ◽  
Atefe Hashemi ◽  
...  
Keyword(s):  
Latent Period ◽  
Case Reports ◽  
Lower Abdominal Pain ◽  
Abnormal Uterine Bleeding ◽  
Total Abdominal Hysterectomy ◽  
Normal Pregnancy ◽  
Abdominal Hysterectomy ◽  
Uterine Bleeding ◽  
Gestational Choriocarcinoma ◽  
Irregular Border

Introduction: Choriocarcinoma (CC) is a rare malignant tumor of trophoblastic tissue. This tends to invade rapidly to the vasculature and metastasis to the lung, vagina, brain, and liver. CC can present with a variety of manifestations, such as hemoptysis, gastrointestinal (GI) bleeding, and abnormal uterine bleeding. Commonly, the latent period to the development of CC is not more than 1 year after the antecedent molar or normal pregnancy. In this report, the patient developed CC about 32 months after her previous known pregnancy. We reported a rare case of gestational CC that occurred about 32 months after her antecedent pregnancy. Case Presentation: A 21-year-old admitted in shock with abnormal uterine bleeding, pain, and lower abdominal pain. The patient had one previous cesarean section 32 months prior to admission. The vaginal examination demonstrated a fused solid cervical mass with an irregular border measuring about 7 × 7 cm. In further workup, there was evidence of a 103 × 94 × 89 mm mass with the hemorrhagic area and central necrosis in the middle and lower segments of the uterus and cervix. The patient underwent a total abdominal hysterectomy and left side salpingo-oophorectomy. The diagnosis of CC was made after microscopic examination. Conclusions: There are few case reports of choriocarcinoma with more than a year latent period after antecedent pregnancy. The strongest hypothesis is having asymptomatic pregnancy during the period between the last pregnancy and the development of CC. However, the possibility of non-gestational choriocarcinoma in such cases should be considered. Treatment with a single- or multiple-agent chemotherapy regimen should be immediately initiated after diagnosis in these cases.

scholarly journals TOTAL ABDOMINAL HYSTERECTOMY FOLLOWED BY BILATERAL SALPINGO-OOPHORECTOMY AND SUBMUCOUS FIBROID REMOVAL

2021 ◽  
Vol 10 (5) ◽  
pp. 3624-3626
Author(s):  
Sakshi P. Arora
Keyword(s):  
Lower Abdominal Pain ◽  
Abnormal Uterine Bleeding ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Fallopian Tubes ◽  
Beneficial Effects ◽  
Delivery Technique ◽  
Vertical Incision ◽  
The Us ◽  
Clinical Conditions

There was abnormal uterine bleeding and recurrent lower abdominal pain in a 50 year-old female. A bilateral salpingo-oophorectomy is surgery to extract ovaries and fallopian tubes of both the sides. By the age of 60, more than a third of women in the US have had a hysterectomy. The expected anatomy, the patient's body habits, the degree of pelvic relaxation, the need for concurrent abdominal and vaginal procedures, and the surgeon's expertise all play a role in deciding the uterus delivery technique and route. The hysterectomy and bilateral salpingo-oophorectomy will both be done during one procedure. The uterus, ovaries, cervix & fallopian tubes are remove through surgery. For a large sub mucous fibroid uterus, the patient opted to have a complete abdominal hysterectomy along bilateral salpingo-oophorectomy. Abdominal hysterectomy & bilateral salpingo-oophorectomy were performed in midline vertical incision under general anesthesia. A uterus with sub mucous fibroid (polyps) was confirmed by pathology. The option of surgical method in a hysterectomy based on clinical conditions, the professional skill of the surgeon, and the preference of patients. As this case indicates, for many patients, abdominal hysterectomy is an important choice where the use of other methods may pose a serious danger. This method may be sufficient for the treatment of sub-mucous fibroids. There are broad range of studies that demonstrate beneficial effects in the various therapies created, serving as a basis for guiding physiotherapeutic approaches in hysterectomy, aiming at complementary tools for better treatment of the patient undergoing this procedure.

scholarly journals Primary High-grade Serous Carcinoma of the Fallopian Tube as an Incidental Intraoperative Finding: A Case Report

2021 ◽  
Vol 18 (3) ◽  
Author(s):  
Nasim Shokouhi ◽  
Sara Saeedi ◽  
Soheila Sarmadi ◽  
Behnaz Moradi ◽  
Elham Feizabad
Keyword(s):  
Fallopian Tube ◽  
Frozen Section ◽  
Gynecologic Cancer ◽  
Total Abdominal Hysterectomy ◽  
Serous Carcinoma ◽  
Histopathological Diagnosis ◽  
High Grade ◽  
Delay In Diagnosis ◽  
Left Fallopian Tube ◽  
Specific Symptoms

: Primary carcinoma of the fallopian tube is a rare, but fatal gynecologic cancer. The preoperative diagnosis of this carcinoma is challenging due to the absence of specific symptoms and signs, and in most patients, it is an intraoperative finding. A 55-year-old patient (G3Ab1P2) was referred to the urogynecology clinic of our hospital with the chief complaints of heavy, prolonged menstrual bleeding and a persistently abnormal yellow discharge, which could not be distinguished by the patient from urinary leaks. After a complete diagnostic work-up, the patient was identified as a candidate for hysterectomy due to abnormal vaginal bleeding resistant to megestrol acetate, family history of malignancy, and abnormal vaginal discharge. Laparotomy revealed unusual left fallopian tube features (large, bulky, and vegetative), suggesting malignancy. The intraoperative frozen-section analysis of the left fallopian tube and the ovarian specimens indicated the mass as a high-grade serous carcinoma of the fallopian tube. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, and partial omentectomy were performed for the patient. The definitive histopathological diagnosis was high-grade serous carcinoma of the left fallopian tube (stage 2b) with omental involvement, without any evidence of lymphovascular invasion. High-grade serous carcinoma of the fallopian tube is likely to have non-specific symptoms, causing a significant delay in diagnosis and treatment, which negatively affects the prognosis and survival of these patients.

scholarly journals A 54-Year-Old Woman with Progressive Ataxia

2016 ◽  
Vol 11 (3) ◽  
Author(s):  
Kun Huang MD PhD ◽  
Robin Parker MD FRCPC ◽  
Tabassum Firoz MD FRCPC
Keyword(s):  
Clinical Manifestations ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Cerebellar Degeneration ◽  
Serous Carcinoma ◽  
High Grade ◽  
Gynecological Cancers ◽  
Progressive Ataxia ◽  
Progressive Cerebellar Ataxia ◽  
Occult Malignancy

Paraneoplastic cerebellar degeneration (PCD) is a rare but devastating syndrome associated with autoantibodies targeting cerebellar antigens expressed by tumours outside of nervous system. PCD is most often associated with breast and gynecological cancers and can precede clinical manifestations of the cancer. Of the dozen autoantibodies associated with PCD, anti-Yo is the most commonly identified. In this report, we present a case of a woman with progressive cerebellar ataxia and anti-Yo antibody, who has microscopic high-grade serous carcinoma found with empiric total abdominal hysterectomy bilateral salpingo-oophorectomy (TAH-BSO). This case highlights the challenges in diagnosis, difficulty in identifying the occult malignancy, and the need for multidisciplinary collaboration between Internal Medicine, Neurology, Gynecology and Pathology. The literature relating to diagnosis, prognosis and treatment of PCD is also reviewed.

scholarly journals Current treatment of double hit and double expressor lymphoma

Hematology ◽  
2017 ◽  
Vol 2017 (1) ◽  
pp. 295-297 ◽  
Author(s):  
Patrick M. Reagan ◽  
Andrew Davies
Keyword(s):  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Current Treatment ◽  
Current Data ◽  
Lymphoid Cells ◽  
High Grade ◽  
Computed Tomography Scans

Abstract A 60-year-old female presented with abdominal pain and distension. Following computed tomography scans of the abdomen and pelvis, she was taken urgently to the operating room, with the belief that she had appendicitis with perforation. At laparotomy, the findings were consistent with an ovarian carcinoma; there was extensive infiltration of the ovary, bowel, and omental deposits. Cytoreductive surgery was performed including total abdominal hysterectomy and bilateral salpingo-oophorectomy. The final pathology, however, revealed infiltration with medium-sized atypical lymphoid cells positive for CD20, CD10, MYC, BLC2, and BCL6 by immunohistochemistry. MYC and BCL2 translocations were identified by fluorescence in situ hybridization consistent with a diagnosis of high-grade B-cell lymphoma with rearrangements of MYC and BCL2. With the current data available, what is the optimal treatment of this patient?

scholarly journals Adenoid Basal Carcinoma of Cervix: A Rare Case Report

2020 ◽  
Vol 3 (2) ◽  
pp. 392-394
Author(s):  
Alina Karna ◽  
Nisha Sharma
Keyword(s):  
Pap Smear ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Adenoid Cystic ◽  
Carcinoma Of Cervix ◽  
Rare Case Report ◽  
Intraepithelial Lesion

Adenoid basal carcinoma of the uterine cervix is a rare low-grade tumor and its cell origin is still obscure. Adenoid basal carcinoma can be confused with adenoid basal hyperplasia, adenoid cystic carcinoma, and basaloid squamous cell carcinoma of the cervix. We present here a case of a 59 year-old-female who initially presented with a high-grade squamous intraepithelial lesion on Pap smear. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Histopathology revealed focal invasive adenoid basal carcinoma with extensive areas of a high-grade squamous intraepithelial lesion involving the endocervical gland. The immunohistochemical stain was positive for p16.

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