Tubal carcinoma/malignancy

Primary fallopian tube carcinoma (PFTC) is among the rarest gynecologic malignancies, accounting for 0.3% of all gynecologic cancers, and is usually seen in postmenopausal women. There is recent evidence that the majority of high-grade, papillary serous cancers involving the ovary may actually originate in the fallopian tube, then spread to the ovary. There is a precursor lesion of the fallopian tube called serous intraepithelial tubal carcinoma (STIC) that is similar to high-grade ovarian serous adenocarcinoma. Recent research suggests that many ovarian cancers originate from a STIC in the fimbriated end of the fallopian tube. Histologically, up to 90% of tubal cancers are adenocarcinomas, most of which are serous adenocarcinomas. A minority of cases are endometrioid and clear cell adenocarcinoma. The risk factors for tubal cancer are similar to ovarian, including the inheritance of the BRCA 1 and BRCA 2 gene mutations. Approximately 15% to 45% of women with fallopian tube cancer are positive for one of these two mutations. Although the symptoms are nonspecific and may include pain and bleeding, tubal cancer has historically been associated with a characteristic watery vaginal discharge. The Latzko triad includes serosanguineous discharge, colicky pelvic pain, and a mass. Although this triad of symptoms is considered characteristic of tubal cancers, it occurs in only 15% of affected patients.