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Aim: To investigate the distribution of tubal endometriosis (EM) in the right and left sides and four parts of the fallopian tube. Methods: A retrospective, cross‐sectional study was conducted on patients with tubal EM at the Fourth Affiliated Hospital of Guangxi Medical University from October 2011 to September 2021. Chi‐square and binomial tests were used for analysis. Results: Thirty‐four patients (53.97%) had tubal resection due to EM (EM group). Twenty‐nine patients (46.03%) had tubal resection due to non‐EM (non‐EM group). Thirty‐two patients (50.80%) had left fallopian tube EM, 21 (33.33%) had right fallopian tube EM, and 10 (15.87%) had bilateral fallopian tube EM, with significant differences among them (p = 0.000). In the EM group, 15 patients (44.12%) had left fallopian tube EM, 13 (38.23%) had right fallopian tube EM, and 6 (17.65%) had bilateral fallopian tube EM (p = 0.052). In the non‐EM group, statistically different (p = 0.001) diagnoses of left fallopian tube EM, right fallopian tube EM, and bilateral fallopian tube EM were 17 (58.62%), 8 (27.59%), and 4 (13.79%), respectively. In the EM group, 18 patients (52.94%) were in the ampullary region; 16 (47.06%) were in the nonampullary region (p = 0.864). In the non‐EM group, 22 cases (75.86%) were in the ampullary region and 7 (24.14%) were in the nonampullary region, with a significant difference between them (p = 0.008). Conclusions: The incidence of left fallopian tube EM was higher than that of right and bilateral fallopian tube EM. The incidence of tubal ampullary EM was higher than that of nonampullary region. [ABSTRACT FROM AUTHOR]

Aim: Ectopic pregnancy implantation on the tubal stump after salpingectomy is a rare location for extrauterine pregnancy, whose pathogenesis is still unknown. The purpose of this study was to examine whether the time interval elapsed from salpingectomy may predispose the embryo to implantation on the tubal stump in the next pregnancy subsequent to tube removal. Methods: Nine women operated for stump pregnancy (study group) between 2008 and 2019 were retrospectively identified. For each case in the study group, 12 consecutive cases that underwent laparoscopic salpingectomy constituted the control group. A sample size of 100 control patients was calculated to achieve statistical power (97.8%) and an α of 0.05. The control groups were triple‐matched with the study group for patients' age, indications for salpingectomy (tubal pregnancy or hydrosalpinx prior to in vitro fertilization treatment) and mode of conception of the subsequent pregnancy following salpingectomy. Results: Nine women underwent surgery for stump pregnancy during the study period. All women had a surgical history of laparoscopic salpingectomy. The time interval from prior salpingectomy to subsequent pregnancy was significantly shorter in study group than in the control group (4.3 ± 2.1 months vs. 15.6 ± 13.7 months, respectively, p = 0.016). Conclusion: A possible association between the short time interval from prior salpingectomy to ectopic implantation on the tubal stump in the subsequent pregnancy was found. The clinical implications of these findings and in particular whether patients should be advised to wait at least 4 months from the salpingectomy to the subsequent pregnancy remain unclear. [ABSTRACT FROM AUTHOR]

Aim: To present our experiences in isolated fallopian tubal torsion (IFTT) case series, which are difficult to diagnose, in light of the literature. Methods: The data of the patients diagnosed with IFTT surgically in our tertiary hospital between 2018 and 2019 were evaluated. Results: Abdominal lower quadrant pain was present in all nine cases. Abdominal pain was accompanied by nausea in five of the nine cases with vomiting in four of the nine cases. Seven of the patients had pain radiating to the vagina. Only one case of IFTT was diagnosed with transvaginal ultrasonography where left tubal dilation and free fluid in the abdomen was found. Two of the nine cases were operated on with a preoperative diagnosis of IFTT. Seven cases were approached laparoscopically and two cases underwent a laparotomy. During the treatment, two of the nine cases underwent detorsion, while seven of the patients underwent a salpingectomy. Conclusion: IFTT is a very rare condition. Therefore, it is difficult to diagnose as it does not come to mind at first glance. Delay of the operation reduces the chance of preserving the tube. [ABSTRACT FROM AUTHOR]

We present the case of a 26‐year‐old multiparous woman who experienced rupture of a tubo‐ovarian abscess during the second trimester of pregnancy. She presented with epigastric and right lower quadrant pain at 12 + 0 weeks' gestation. There were no other specific findings on the magnetic resonance imaging images. We recommended hospitalization to observe the changes in pain, but she refused confinement. About 3 weeks later, she revisited our emergency room at 15 + 4 weeks' gestation. She complained of worsening abdominal pain with fever. She underwent right salpingo‐oophorectomy and appendectomy due to uncontrollable, severe abdominal pain without any obstetric abnormal condition. There was a rupture site in the right adnexa, which was covered with pus. The rupture of tubo‐ovarian abscess during pregnancy is very rare. Therefore, obstetricians should carefully monitor the adnexal masses observed during pregnancy, which should be treated with caution, whether or not the patient is symptomatic. [ABSTRACT FROM AUTHOR]

Aim: The purpose is to investigate pain perception during transvaginal four‐dimensional hysterosalpingo‐contrast sonography (TV 4D‐HyCoSy) and factors influencing pain severity. Methods: This was a retrospective study included 340 women who underwent TV 4D‐HyCoSy examination from January 2016 to October 2017. The factors were recorded, including age, childbearing history, infertility type, history of pelvic inflammation, pelvic surgery, history of uterine manipulation, history of ectopic pregnancy, atropine delivery mode, uterine position, uterine malformation, uterine lesion, fibroid, intrauterine adhesion, polycystic ovary, endometrial implantation cyst, dysmenorrhea score, the degree of patency of fallopian tube and contrast agents dosage. Pain was evaluated during and after TV 4D‐HyCoSy. The time point of peak pain was evaluated and the influencing factors of moderate/severe pain were analyzed. Results: The highest pain occurred at contrast instillation. The independent influencing factors of moderate/severe pain were age (P = 0.021), dysmenorrhea score (P = 0.003) and tubal patency (P < 0.001). Further analysis showed that age affected the pain score when TV 4D‐HyCoSy started and the peak pain occurred. Dysmenorrhea score and tubal patency affect the pain score at most time points. Conclusion: Age, dysmenorrhea score and tubal patency are factors influencing the severity of pain during TV 4D‐HyCoSy. [ABSTRACT FROM AUTHOR]

A 30‐year‐old nulliparous woman was transferred under suspicion of acute appendicitis, due to the sudden onset of severe right lower quadrant pain at 31 weeks and 4 days of gestation. Magnetic resonance imaging showed a cystic mass measuring 40 mm in diameter in the right lower abdomen. Because the right ovary without edematous swelling was noted adjacent to the cystic mass, isolated tubal torsion was strongly suspected. Emergency gasless laparoendoscopic single‐site surgery showed isolated torsion of the right fallopian tube with a paratubal cyst. The right ovary was not involved in this torsion. Because the color tone of the distal portion of the fallopian tube did not recover sufficiently after detorsion, right salpingectomy was performed. Postoperatively, the infusion of magnesium sulfate was initiated due to increased uterine contraction and continued until 36 weeks of gestation. At 38 weeks and 1 day of gestation, uneventful vaginal delivery yielded a healthy female infant. [ABSTRACT FROM AUTHOR]

Hematosalpinx is the accumulation of blood in fallopian tubes. Its most common cause is ectopic pregnancy, but the other causes include pelvic inflammatory disease (PID), endometriosis and pelvic trauma. We report a rare case of hematosalpinx in a 45‐year‐old female with no obvious cause. She presented with acute sharp right iliac fossa pain not relieving with analgesics. She did not have a history of fever, PID, endometriosis, or trauma. Her menstrual cycle was also normal and β‐hcG was negative. Ultrasound showed the right ovarian cyst and was suggesting of hemorrhagic. She was operated and a large hematosalpinx was observed. This rare case suggests the possibility of Hematosalpinx in the mid‐40s besides ruling out the possibility of some of the causes hypothesized in the relevant literature. The case highlights the need to better understand the pathophysiology of hematosalpinx. [ABSTRACT FROM AUTHOR]

Sarcoidosis is a systemic granulomatous disease that is most commonly manifested in the pulmonary system. Though the entire etiology of sarcoidosis remains unknown, it has been reported that Propionibacterium acnes (P. acnes) has been isolated from sarcoid lesions. Herein, we report a case of salpingitis arising from sarcoidosis. A female patient aged 37 years, gravida 2 para 0, who had been diagnosed with sarcoidosis at the age of 36 years, underwent laparoscopic right salpingectomy due to obvious right hydrosalpinx with recurrent refractory right lower abdominal pain. The pathological diagnosis was granulomatous salpingitis of the right fallopian tube suspecting sarcoidosis. Immunocytochemistry using a specific monoclonal antibody against P. acnes lipoteichoic acid (PAB antibody) revealed PAB‐positive reaction in sarcoid granuloma. This is the first case of sarcoidosis that the presence of P. acnes was shown in sarcoid lesions in the fallopian tube. [ABSTRACT FROM AUTHOR]

Aim The aim of our study was to assess the levels of human epididymis protein 4 (HE4) with the common tumor marker carbohydrate antigen 125 (CA125) in the diagnosis and monitoring of therapy for primary fallopian tube carcinoma (PFTC). Methods Serum HE4 and CA125 levels from 82 PFTC patients and 154 patients with benign pelvic masses as the control were measured by Roche electrochemiluminescent immunoassay. HE4 determinations for surgery response and recurrence monitoring were assessed in PFTC patients. Results Serum HE4 and CA125 concentrations were significantly higher in PFTC patients compared with those seen in patients with benign pelvic masses ( P < 0.001). Compared with CA125, HE4 had higher specificity, but lower sensitivity whether at early or advanced stage, and the combination of HE4 + CA125 led to higher sensitivity and specificity. HE4 + CA125 performed significantly better than CA125 or HE4 alone in early stage patients. In early stage the sensitivity was 35.7% for HE4 and 64.3% for CA125, while sensitivity for the combination of HE4 and CA125 could reach 71.4%. Furthermore, the two markers were associated with the progression and histology of PFTC. Serum HE4 level was closely correlated with surgical therapy. PFTC patients displayed a greater decline in the level of HE4 compared with CA125 (76.4% vs 55.7%). Combined with CA125, HE4 elevation better predicted recurrence in PFTC patients. Conclusions This study indicated that serum HE4 levels are closely associated with PFTC and the outcome of surgical therapy and recurrence in Chinese patients. [ABSTRACT FROM AUTHOR]

Aim Inflammation of the upper genital tract causes pelvic inflammatory disease ( PID), which may be complicated by pelvic abscesses, such as pyosalpinx and tubo-ovarian abscess ( TOA). This study aimed to determine the clinical differences between pyosalpinx and TOA in patients with PID. Material and Methods We retrospectively evaluated 458 female patients who were admitted to Hallym University Kang Dong Sacred Heart Hospital for a clinical diagnosis of PID from 1 January 2007 to 30 April 2012. Sociodemographic, clinical and laboratory data were compared among the non-abscess, pyosalpinx, and TOA groups. Results We identified 110 patients (24%) diagnosed with pelvic abscess associated with PID, including 34 with pyosalpinx and 76 with TOA. The pyosalpinx group had shorter hospital stays ( P = 0.007), lower C-reactive protein levels ( P = 0.015), smaller mass sizes ( P < 0.001), and fewer surgical interventions ( P < 0.001) than the TOA group. Conclusions Pyosalpinx is a less severe form of PID that leads to shorter hospital stays and more favorable outcomes than TOA. [ABSTRACT FROM AUTHOR]

Cerebral recurrence from Müllerian cancer is a rare event and prognosis of patients with such a condition is poor. We report a case of cerebral recurrence from International Federation of Gynecology and Obstetrics classification stage IV tubal cancer presenting with inguinal lymphadenopathy. The patient achieved more than 7 years' disease-free survival after irradiation to the brain despite the inauspicious event. The present case had a rare clinical course in terms of primary site, primary symptom, failure site, and clinical outcome. Patients with brain metastasis from Müllerian cancer have a chance for long-term survival under specified circumstances, such as solitary metastasis, no extracranial metastasis, no recurrence preceding brain metastasis and small tumor size. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to identify factors that can predict the resistance to parenteral therapy in patients with tubo-ovarian abscesses ( TOA). Material and Methods We conducted a case-control study involving 55 admitted patients with TOA. The subjects eligible for this study included 28 patients who failed antibiotic therapy and required surgery (surgical cases) and 27 patients who were conservatively cured (control cases). The clinical characteristics of the patients on admission were reviewed. Logistic regression analysis was performed after univariate analysis to identify potentially important variables and to calculate odds ratios with 95% confidence intervals. Results As per the univariate analysis, compared to the control cases, the surgical cases were older (40.4 vs 31.5 years), had higher white blood cell counts (14000 vs 11828 cells/mm3), higher C-reactive protein levels (16.1 vs 7.6 mg/dL), and a larger abscess diameter (6.6 vs 3.9 cm). There were no significant differences in gravidity, parity, body temperature, rate of endometrial cyst formation, and Chlamydia trachomatis infection rates between the groups. Multiple logistic regression analysis indicated that the only statistically significant risk factor predicting parenteral antibiotic therapy failure was the abscess diameter >5 cm (odds ratio = 69.6; 95% confidence interval = 9.3-527, P < 0.0001). Conclusion An abscess diameter >5 cm is an important factor for predicting the failure of antibiotic therapy in patients with TOA. Moreover, it is useful for determining whether patients with TOA should be surgically treated. [ABSTRACT FROM AUTHOR]

The fallopian tube is the least common site for origin of malignancy in the female genital tract. Most primary fallopian tube malignancies are adenocarcinomas. Primary transitional cell carcinoma (TCC) of the fallopian tube is an extremely rare tumor with a small number of cases reported in the literature. We present a 67-year-old woman who was found incidentally to have a left adnexal mass on a screening pelvic ultrasound. Subsequently the patient underwent laparoscopic left salpingo-oophorectomy and the specimen was submitted for intraoperative frozen section, which revealed a high-grade carcinoma; therefore, she underwnt a laparotomy and total abdominal hysterectomy, right salpingo-oophorectomy and omentectomy. Histopathology revealed high-grade transitional cell carcinoma in the left fallopian tube. Post-surgery she was treated with four cycles of adjuvant chemotherapy with carboplatin and paclitaxel with no complications. Our patient had a family history of malignancy, so genetic testing for BRCA1 and BRCA2 mutations was undertaken and did not reveal any mutation or unclassified variants. Multiplex ligation-dependent probe amplification (MLPA) was normal. [ABSTRACT FROM AUTHOR]

Diagnosis of Borderline papillary serous tumor of the fallopian tube was comprehensively established by Zheng in 1996 supported mostly by a histological similarity to its ovarian counterpart. It is a very rare entity with eight cases published so far and the ninth case described here as a 41-year-old woman presented with non-specific lower abdominal pain, dyspareunia and dysuria. Left adnexal mass was identified and she was operated on. It turned out the tumor was attached exclusively to the left tube, with no connection to any of the surrounding structures and with histology of borderline serous tumor with non-invasive implants in the left and right ovary and visceral peritoneum. Reviewing available data on genetics of these tumors there was diploid status in one examined tumor, and in our case no mutations of KRAS, BRAF and p53 genes were found. Histomorphology remains the mainstay of diagnosis and staging operation is the mainstay of patient management. Prognosis is uncertain with a 6-year survival documented in one case. [ABSTRACT FROM AUTHOR]