Endometrioid Carcinoma of the Fallopian Tube Resembling a Female Adnexal Tumor of Probable Wolffian Origin

Abstract

Endometrioid carcinoma of the fallopian tube resembling a female adnexal tumor of probable wolffian origin (FATWO) is a rare, recently delineated, low-grade carcinoma that may be confused with both FATWO and high-grade carcinoma. Only about 20 cases have been reported so far, but it probably represents almost half of the endometrioid carcinomas of the fallopian tube. It has a better prognosis than conventional tubal endometrioid and serous carcinomas. Macroscopically, the tumors form a small, solid, polypoid mass that is usually confined within the tube. Microscopically, the tumors are characterized by proliferations of spindle cells in whorls and closely packed confluent elongated glands with focal tubular, sieve-like, and papillary structures. Unlike FATWO, this variant of endometrioid carcinoma exhibits focal squamous differentiation, intraluminal mucin, mild to moderate nuclear atypia, and occasional mitosis. Unlike FATWO, tumor cells are negative for inhibin-alpha and calretinin.

Diagnosis and management of female adnexal tumor of probable Wolffian origin (FATWO) arising from ovary: a case report

“…The role of adjuvant chemotherapy or radiation therapy is controversial (7). Immunohistochemical findings of the case reported are similar to those described by other authors except for inhibin which has not been detected by us (11,12,15). In recurrent or metastatic FATWO, molecular targeted therapy, such as tyrosine kinase inhibitor, could be considered.…”

“…The MRI findings of this tumor were described by Matsuki et al (7) as a slightly hyperintense mass with cystic degeneration in the adnexa, which were difficult to differentiate from a subserosal leiomyoma or an ovarian tumor. The main differential diagnosis includes well differentiated endometrioid ovarian adenocarcinoma, endometrioid adenocarcinoma of the fallopian tube and Sertoli Leydig cell tumor (3,12,13). The main differential diagnosis includes well differentiated endometrioid ovarian adenocarcinoma, endometrioid adenocarcinoma of the fallopian tube and Sertoli Leydig cell tumor (3,12,13).…”

“…The main differential diagnosis includes well differentiated endometrioid ovarian adenocarcinoma, endometrioid adenocarcinoma of the fallopian tube and Sertoli Leydig cell tumor (3,12,13). The degree of nuclear atypia and mitotic activity is more impressive in endometrioid adenocarcinoma (12). The degree of nuclear atypia and mitotic activity is more impressive in endometrioid adenocarcinoma (12).…”

Female adnexal tumor of probable Wolffian origin arising from mesosalpinx: A case report and review

“…The main differential diagnosis in histology includes endometrioid carcinoma of the fallopian tube, Sertoli‐Leydig cell tumor and broad ligament granulosa cell tumor (GCT) . Endometrioid carcinomas arises from the fallopian tube, whereas FATWO is extratubal and usually arises within the broad ligament .…”

Value of Calretinin Immunostaining in Diagnostic Pathology

“…In those instances in which this differential diagnosis arises, immunostaining for calretinin, combined with SALL4, a germ cell tumor marker that is consistently expressed in yolk sac tumors, but absent in granulosa cell tumors, can assist in distinguishing between these 2 malignancies. [104][105][106][107][108] The main differential diagnosis of FAT-WO is with endometrioid carcinomas arising in the fallopian tube and ovarian sex cord-stromal tumors, such as granulosa cell tumors and Sertoli cell tumors. 11,28,[37][38][39][40][41][42][43]48,87,101 Female adnexal tumor of probable Wolffian origin (FATWO) is a distinctive, usually benign, neoplasm that most commonly arises in the broad ligament and is thought to be derived from mesonephric remnants that frequently occur in this area.…”