Primary fallopian tube carcinoma: a clinicopathological analysis of a rare entity.

BACKGROUND: The aim of this study was to evaluate the clinical and pathological features of a rare tumor, primary fallopian tube carcinoma (PFTC). MATERIALS AND METHODS: We retrospectively analyzed the medical records of 26 patients who were diagnosed with PFTC at Cheil General Hospital and Women's Healthcare Center between March 1992 and November 2009. RESULTS: Median patient age was 54.6 (range 41-69) years, and the mean follow-up period was 59.8 (range 3-200) months. Twenty-one (80.8%) patients had one or more of the following preoperative symptoms: vaginal bleeding, abdominal pain, or a palpable mass. No patient was diagnosed with PFTC preoperatively; 17 (65.4%) patients were diagnosed as having an adnexal mass, six (23.1%) had hydrosalpinx, and three (11.5%) had coexisting endometrial pathology. In seven (26.9%) cases, PFTC was missed during the operation, so an additional surgery was later performed. Ten (38.5%) patients were in stage I, two (7.7%) in stage II, 13 (50%) in stage III, and one (3.8%) in stage IV. The serous type was histologically predominant (76.9%), and most were high grade (76.9%). The 5-year survival rate was 81.7%. CONCLUSION: Primary fallopian tube carcinoma is hardly ever diagnosed preoperatively or intraoperatively due to its rarity. Our report may help surgeons by providing more information about the clinicopathological behavior of PTFC so that patients can be appropriately counseled. Further clinical studies should be performed to collect more information about this rare tumor.

Single-port transumbilical laparoscopic-assisted adnexal surgery.

OBJECTIVES: To evaluate the efficiency and feasibility of single-port access transumbilical laparoscopic-assisted surgery in patients with large (>8cm) adnexal tumors and to present our initial experience. METHODS: Twenty-two patients with presumably benign adnexal tumors who have undergone single-port access transumbilical laparoscopic-assisted surgery were enrolled. The procedure was performed using the method of exteriorization and extracorporeal surgery of adnexal tumors outside the abdominal cavity under laparoscopic guidance with preservation of as much ovarian tissue as possible. In each case, a homemade single-port device was inserted into the abdomen through a 2-cm umbilical incision. The clinical characteristics and operative outcomes of these patients were reviewed. RESULTS: Twenty of 22 cases were completed successfully. The one failed case required an additional trocar for adequate adhesiolysis, and the other case needed intraperitoneal drainage. The median operating time was 50 minutes (range, 35 to 120), and the estimated blood loss was 38mL (range, 10 to 300). Cyst rupture occurred in 2 cases, but there were no major postoperative complications. CONCLUSION: Single-port access transumbilical laparoscopic-assisted surgery for benign and relatively large adnexal tumors is feasible and could be an alternative to convention open laparotomy or laparoscopic surgery.