Medical diligence uncovers fallopian tube cancer after abnormal Pap test

Abstract

The fallopian tube has received attention as an origin of high-grade pelvic malignancies. This is a case of bilateral fallopian tube cancer discovered after an abnormal Pap test. A 62-year-old woman with a history of one term delivery had atypical glandular cells on a Pap test. She had an unsatisfactory colposcopy and a normal transvaginal ultrasound. A loop electrode excision procedure and hysteroscopy with dilation and curettage revealed atypical glandular cells concentrated in floating balls. CA-125 was 10 U/mL. A robotic hysterectomy revealed histopathological stage IIIA serous carcinoma arising from both fallopian tubes. She received six cycles of carboplatin and paclitaxel. After chemotherapy, she has no evidence of disease at 5 years. Fallopian tube carcinoma is a differential diagnosis of abnormal glandular cells on a Pap test. Diagnosis by systematic pursuit of abnormal tests can lead to successful treatment of a small disease burden.

Practical Means of Preoperative Diagnostics of Primary Fallopian Tube Cancer

“…Although according to literature data, accuracy of cytological results varies between 0% and 40%. It is explained by hardship of obtaining cytological sample of sufficient quality and quantity [13][14][15][16]. We specifically examined 95 PFTC patients using different methods of sampling (vaginal and cervical smears; uterine aspirate; discharge on cervical cap; discharge sampled on hysterosaplingography).…”