Primary Fallopian Tube Carcinoma With Omental Metastasis : A Case Report.

Introduction Although there is no data about the incidence of Primary fallopian tube carcinoma in India but in the United States the incidence is 0.41 per 100, 000 population with less than 2000 cases reported all over the world. It is said that Primary fallopian tube carcinoma (PFTC) is very difficult to diagnose preoperatively, so while treating a case of adnexal mass, PFTC should be kept in mind. Case Report Mrs SB, a 57 yrs postmenopausal lady, presented with a history of lower abdominal pain and abnormal discharge per vaginum for 6 weeks. On clinical examination she had mild pallor, Per abdominal examination revealed tenderness on the left illiac fossa, Per vaginally cervix normal, uterus deviated towards the right side with a left adnexal mass with restricted mobility, it was tender on examination. MRI examination revealed a mixed echogenic mass on the left adnexae with normal uterus. PAP smear was normal and S CA125 was 354 U/ml. Patient was taken up for exploratory laparotomy, intraoperatively uterus was normal looking with normal right sided ovary and tube. On the left side ovary was normal however the left fallopian tube was enlarged and firm in consistency with open fimbrial end. Omental nodule was detected on inspection. She had undergone Total abdominal hysterectomy along with B/L salpingooporectomy, omentectomy plus nodal dissection. The postoperative period was uneventful and she was discharged on 5th post operative day. Her final HPE revealed Primary fallopian tube carcinoma (moderately diffentiated papillary adenocarcinoma) with omental metastasis, rest of the specimen was negative for malignancy. She was taken up for adjuvant chemotherapy and she completed six cycles of Paclitaxel plus Carboplatin. At present she is on regular followup for the last six plus years without any evidence of disease. Conclusion : In spite of advanced stage, in our case we had a good prognosis propably due to the absence of lymph nodal metastasis which is one of the important poor prognostic criteria in PFTC also a complete surgical debulking along with proper adjuvant chemotherapy is the key factor in the management of PFTC. [ABSTRACT FROM AUTHOR]