Primary High-Grade Serous Carcinoma of Fallopian Tube, an Incidental Intraoperative Finding: A Case Report

Abstract

Background: Primary carcinoma of fallopian tube is a rare but deadly gynecologic cancer, In addition, its preoperative diagnosis is strict due to the lack of specific symptoms and signs and in most patients, it is an intraoperative finding.Case presentation: A 55-year-old patient, G3Ab1P2 referred to urogynecology clinic of our hospital with chief complaint about heavy, prolonged menstrual bleeding and a permanently abnormal yellow discharge that could not be distinguished from its urinary or vaginal source.After complete diagnostic work-up, the patient became a candidate for hysterectomy due to the drug (Megestrol Acetate) -resistant abnormal vaginal bleeding, her abnormal vaginal bleeding, positive family history of malignancy, and abnormal vaginal discharge.Laparotomy revealed unusual left fallopian tube feature (Large, bulky, and vegetative feature), suspected to malignancy. Intraoperative frozen-section analysis of the left fallopian tube and ovary specimens detected the mass as a high-grade serous carcinoma of fallopian tube. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, and partial omentectomy were performed. The definitive histopathological diagnosis was high-grade serous carcinoma of the left fallopian tube stage 2b with omental involvement without any evidence of lymph-vascular invasion.Conclusions: High-grade serous carcinoma of fallopian tube is likely to present nonspecific symptoms, which may cause considerable delay in diagnosis and treatment. This consequently, affects the prognosis and survival of the patient.