Primary fallopian tube HIGH GRADE SEROSE carcinoma: a case report

Primary fallopian tube carcinoma( PFTC) is on of the rarest gynecologic malignant conditions and has incidence of ۰.۱۴ to ۱.۸% of all gynecologic cancers and has been rising during last decades which varies between ۲.۹/۱,۰۰۰,۰۰ and ۵.۷/۱,۰۰۰,۰۰۰. ۲۰-۳۰ new cases are reported each year on average. Since ۱۸۸۸, over ۲۰۰۰ cases of PFTC are reported.(۱,۲)Molecular, histological and genetic finding showed that the origin of ۴۰-۶۰% of peritoneum or ovary high-grade serous carcinomas are fimbriae and fallopian tube. The definite Etiology of this condition is unknown but is suggested to be related to infertility, chronic salpingitis, tuberculous salpingitis and tubal endometriosis. BRCA germline mutation and TP۵۳ mutation are related to fallopian tube malignancies same as ovarian malignancies. PFTC has clinical symptoms including lower abdominal pain, pelvic pain, serous vaginal discharge and pelvic mass which are non-specific and most cases are diagnosed intraoperatively with histopathological findings.(۲)We are reporting PFTC in a۵۹-years-old female who had lower abdominal pain as her chief complaint.Case presentationA ۵۹-years-old female, Gravida ۴, para ۴ and ۷ years post-menopausal consulted for lower abdominal pain which had started a couple of years before. She had past medical history of diabetes mellitus. No surgical history was remarkable. She had familial history of breast cancer in her aunt which was cured. Her history of vaginal bleeding, vaginal discharge or any gynecologic condition was negative. On her abdominopelvic ultrasound a solid mass was seen on her right adnexa. Her CA-۱۲۵ tumor marker was ۱۰۹ IU/mL and ROMA index was ۴۰%.A midline laparotomy was done and solid vegetation on her right fallopian tube was found, while both ovaries an left fallopian tube were grossly intact (figure۱-۲-۳). A tumor biopsy was sent to frozen section for histopathology and the result showed high grade serous carcinoma of fallopian tube.