Magnetic resonance imaging in diagnosis of serous adenocarcinoma of fallopian tubes: a case report

Abstract

Serous adenocarcinoma of fallopian tubes is an extremely rare and difficult to diagnose type of cancer of the female reproductive system. This condition is often asymptomatic or has a non specific clinical presentation including serosanguineous vaginal discharge and colic like pain in the lower abdomen and pelvis. These symptoms are reported in the literature as the Latzko’s triad and are considered pathognomonic for tubal cancer, but their combination is observed in less than 15% of patients. The low incidence and lack of the pathognomonic clinical presentation lead to many diagnostic errors or detection of advanced disease, which significantly worsens the patient’s prognosis. An accurate surgical diagnosis is made in only 4% of cases. This case report describes serous adenocarcinoma of fallopian tubes with all signs of the Latzko’s triad and MRI suggestive of serous adenocarcinoma of fallopian tubes at a preoperative stage.

Keywords

fallopian tube cancer / serous adenocarcinoma of fallopian tubes / magnetic resonance imaging / case report

References

[1] Meinhold Heerlein I, Fotopoulou C, Harter P, et al. The new WHO classification of ovarian, fallopian tube, and primary peritoneal cancer and its clinical implications. Arch Gynecol Obstet. 2016;293(4):695–700. doi: 10.1007/s00404-016-4035-8

[2] Meinhold Heerlein I., Fotopoulou C., Harter P., et al. The new WHO classification of ovarian, fallopian tube, and primary peritoneal cancer and its clinical implications // Arch Gynecol Obstet. 2016. Vol. 293. N 4. P. 695–700. doi: 10.1007/s00404-016-4035-8

[3] Burghardt E, Girardi F, Lahousen M, et al. Patterns of pelvic and paraaortic lymph node involvement in ovarian cancer. Gynecol Oncol. 1991;40(2):103–106. doi: 10.1016/0090-8258(91)90099-q

[4] Burghardt E., Girardi F., Lahousen M., et al. Patterns of pelvic and paraaortic lymph node involvement in ovarian cancer // Gynecol Oncol. 1991. Vol. 40. N 2. P. 103–106. doi: 10.1016/0090-8258(91)90099-q

[5] Stasenko M, Fillipova O, Tew W. Fallopian Tube Carcinoma. J Oncol Pract. 2019;15(7):375–382. doi: 10.1200/JOP.18.00662

[6] Stasenko M., Fillipova O., Tew W. Fallopian Tube Carcinoma // J Oncol Pract. 2019. V. 15. N 7. P. 375–382. doi: 10.1200/JOP.18.00662

[7] Reid B, Permuth J, Sellers T. Epidemiology of ovarian cancer: a review. Cancer Biol Med. 2017;14(1):9–32. doi: 10.20892/j.issn.2095-3941.2016.0084

[8] Reid B., Permuth J., Sellers T. Epidemiology of ovarian cancer: a review // Cancer Biol Med. 2017. Vol. 14. N. 1. P. 9–32. doi: 10.20892/j.issn.2095-3941.2016.0084

[9] Ulrikh EA, Papunidi МD, Urmancheeva AF, Matsko DE. Fallopian tube carcinoma: clinical and morphological features, analysis of 69 cases. Voprosy onkologii. 2014;60(3):375–378. EDN: SJTCOH

[10] Ульрих Е.А., Папуниди М.Д., Урманчеева А.Ф., Мацко Д.Е. Рак маточный трубы: клинико-морфологические особенности, анализ 69 случаев // Вопросы онкологии. 2014. Т. 60. № 3. С. 375–378. EDN: SJTCOH

[11] Kim MY, Rha SE, Oh SN, et al. MR Imaging findings of hydrosalpinx: a comprehensive review. Radiographics. 2009;29(2):495–507. doi: 10.1148/rg.292085070

[12] Kim M.Y., Rha S.E., Oh S.N., et al. MR Imaging findings of hydrosalpinx: a comprehensive review // Radiographics. 2009. Vol. 29. N 2. P. 495–507. doi: 10.1148/rg.292085070

[13] Riska A, Leminen A. Updating on primary fallopian tube carcinoma. Acta Obstet Gynecol Scand. 2007;86:1419–1426. doi: 10.1080/00016340701771034

[14] Riska A., Leminen A. Updating on primary fallopian tube carcinoma // Acta Obstet Gynecol Scand. 2007. Vol. 86. N 12. P. 1419–1426. doi: 10.1080/00016340701771034

[15] PDQ Adult Treatment Editorial Board. Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment (PDQ®): Health Professional Version. 2023. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US), 2002. Available from: https://www.ncbi.nlm.nih.gov/books/NBK66007/

[16] PDQ Adult Treatment Editorial Board. Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment (PDQ®): Health Professional Version. 2023 // PDQ Cancer Information Summaries [Internet]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK66007/

[17] Kalampokas E, Kalampokas T, Tourountous I. Primary fallopian tube carcinoma. Eur J Obstet Gynecol Reprod Biol. 2013;169(2):155–161. doi: 10.1016/j.ejogrb.2013.03.023

[18] Kalampokas E., Kalampokas T., Tourountous I. Primary fallopian tube carcinoma // Eur J Obstet Gynecol Reprod Biol. 2013. Vol. 169. N 2. P. 155–161. doi: 10.1016/j.ejogrb.2013.03.023

[19] Carvalho J, Moretti Marques R, Filho A. Adnexal mass: diagnosis and management. Rev Bras Ginecol Obstet. 2020;42(7):438–443. doi: 10.1055/s-0040-1715547

[20] Carvalho JP, Moretti Marques R, Filho A. Adnexal mass: diagnosis and management // Rev Bras Ginecol Obstet. 2020. Vol. 42. N 7. P. 438–443. doi: 10.1055/s-0040-1715547

[21] Anthoulakis C, Nikoloudis N. Pelvic MRI as the ”gold standard” in the subsequent evaluation of ultrasound indeterminate adnexal lesions: a systematic review. Gynecol Oncol. 2014;132(3):661–668. doi: 10.1016/j.ygyno.2013.10.022

[22] Anthoulakis C., Nikoloudis N. Pelvic MRI as the ”gold standard” in the subsequent evaluation of ultrasound indeterminate adnexal lesions: a systematic review // Gynecol Oncol. 2014. Vol. 132. N 3. P. 661–668. doi: 10.1016/j.ygyno.2013.10.022

[23] Nishino M, Hayakawa K, Minami M, et al. Primary retroperitoneal neoplasms: CT and MR imaging findings with anatomic and pathologic diagnostic clues. Radiographics. 2003;23(1):45–57. doi: 10.1148/rg.231025037

[24] Nishino M., Hayakawa K., Minami M., et al. Primary retroperitoneal neoplasms: CT and MR imaging findings with anatomic and pathologic diagnostic clues // Radiographics. 2003. Vol. 23. N 1. P. 45–57. doi: 10.1148/rg.231025037

[25] Sadowski E, Thomassin Naggara I, Rockall A, et al. O-RADS MRI Risk Stratification System: Guide for Assessing Adnexal Lesions from the ACR O-RADS Committee. Radiology. 2022;303(1):35–47. doi: 10.1148/radiol.204371

[26] Sadowski E., Thomassin Naggara I., Rockall A., et al. O-RADS MRI Risk Stratification System: Guide for Assessing Adnexal Lesions from the ACR O-RADS Committee // Radiology. 2022. Vol. 303. N 1. P. 35–47. doi: 10.1148/radiol.204371

[27] Bulanov MN, Chekalova MA, Mazurkevich MN, Vetsheva NN. Primenenie sistemy O-RADS pri ultrazvukovom issledovanii pridatkov matki. Moscow: Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Health Care Department, 2022. 27 p. (In Russ.) EDN: BUBNGP

[28] Буланов М.Н., Чекалова М.А., Мазуркевич М.Н., Ветшева Н.Н. Применение системы O-RADS при ультразвуковом исследовании придатков матки. М.: Научно-практический клинический центр диагностики и телемедицинских технологий Департамента здравоохранения города Москвы. 2022. 27 c. EDN: BUBNGP

[29] Veloso G, Dias F, Lucas R, Cunha T. Primary fallopian tube carcinoma: review of MR imaging findings. Insights Imaging. 2015;6(4):431–439. doi: 10.1007/s13244-015-0416-y

[30] Veloso G., Dias F., Lucas R., Cunha T. Primary fallopian tube carcinoma: review of MR imaging findings // Insights Imaging. 2015. Vol. 6. N 4. P. 431–439. doi: 10.1007/s13244-015-0416-y

[31] Duska LR, Kohn EC. The new classifications of ovarian, fallopian tube, and primary peritoneal cancer and their clinical implications. Ann Oncol. 2017;28(suppl_8):viii8-viii12. doi: 10.1093/annonc/mdx445

[32] Duska L., Kohn E. The new classifications of ovarian, fallopian tube, and primary peritoneal cancer and their clinical implications // Ann Oncol. 2017. Vol. 28. Suppl. 8. P. viii8-viii12. doi: 10.1093/annonc/mdx445

[33] Nudnov NV, Ivashina SV, Aksenova SP. Radiation methods in the diagnosis of primary and recurrent malignant ovarian struma: A case report. Digital Diagnostics. 2023;4(2):214−225. EDN: YNASOM doi: 10.17816/DD322846

[34] Нуднов Н.В., Ивашина С.В., Аксенова С.П. Лучевые методы в диагностике первичной и рецидивной злокачественной струмы яичников: клинический случай // Digital Diagnostics. 2023. Т. 4, № 2. С. 214−225. EDN: YNASOM doi: 10.17816/DD322846

[35] Klinicheskie rekomendatsii MZ RF "Rak yaichnikov / rak matochnoi truby / pervichnyi rak bryushiny". 2022. Ministerstvo zdravookhraneniya RF. Available from: https://oncology.ru/specialist/treatment/references/actual/547.pdf

[36] Клинические рекомендации МЗ РФ «Рак яичников / рак маточной трубы / первичный рак брюшины». 2022 г. Министерство здравоохранения РФ. Режим доступа: https://oncology.ru/specialist/treatment/references/actual/547.pdf

[37] Singh N, Gilks C, Wilkinson N, et al. Assignment of primary site in high grade serous tubal, ovarian and peritoneal carcinoma: a proposal. Histopathology. 2014;65(2):149–154. doi: 10.1111/his.12419

[38] Singh N., Gilks C., Wilkinson N., et al. Assignment of primary site in high grade serous tubal, ovarian and peritoneal carcinoma: a proposal // Histopathology. 2014. Vol. 65. N 2. P. 149–154. doi: 10.1111/his.12419

[39] Zhordania KI, Payanidi YuG, Kalinicheva EV. Two ways of the development of serous epithelial ”Ovarian” cancer. Oncogynecology. 2014;(3):42–48. EDN: TAOOQL

[40] Жорданиа К.И., Паяниди Ю.Г., Калиничева Е.В. Два пути развития серозного рака яичников // Онкогинекология. 2014. № 3. С. 42–48. EDN: TAOOQL

[41] Zhordania KI, Payanidi YuG, Kalinicheva EV. Novaya paradigma v etiologii seroznogo raka yaichnikov. Rossiiskii bioterapevticheskii zhurnal. (In Russ.) 2014;13(2):95–102. EDN: SNANEL

[42] Жорданиа К.И., Паяниди Ю.Г., Калиничева Е.В. Новая парадигма в этиологии серозного рака яичников // Российский биотерапевтический журнал. 2014. Т. 13, № 2. С. 95–102. EDN: SNANEL

[43] Zhordania KI. Serous ovarian carcinoma or serous carcinoma of uterine (fallopian) tube? Oncogynecology. 2012;(3):4–9. EDN: SZRFTZ

[44] Жорданиа К.И. Серозный рак яичников или серозный рак маточной трубы? // Онкогинекология. 2012. № 3. С. 4–9. EDN: SZRFTZ

[45] SEER*Explorer: An interactive website for SEER cancer statistics [Internet]. Surveillance Research Program, National Cancer Institute; 2023. Available from: https://seer.cancer.gov/statistics network/explorer/

[46] Tokunaga H., Mikami M., Nagase S., et al. The 2020 Japan Society of Gynecologic Oncology guidelines for the treatment of ovarian cancer, fallopian tube cancer, and primary peritoneal cancer // J Gynecol Oncol. 2021. Vol. 32. N 2. P. e49. doi: 10.3802/jgo.2021.32.e49

[47] Tokunaga H, Mikami M, Nagase S, et al. The 2020 Japan Society of Gynecologic Oncology guidelines for the treatment of ovarian cancer, fallopian tube cancer, and primary peritoneal cancer. J Gynecol Oncol. 2021;32(2):e49. doi: 10.3802/jgo.2021.32.e49

[48] SEER*Explorer: An interactive website for SEER cancer statistics [Internet]. Surveillance Research Program, National Cancer Institute. 2023. Available from: https://seer.cancer.gov/statistics network/explorer/

[49] Kuroki L, Guntupalli SR. Treatment of epithelial ovarian cancer. BMJ. 2020;371:m3773. doi: 10.1136/bmj.m3773

[50] Kuroki L., Guntupalli S. Treatment of epithelial ovarian cancer // BMJ. 2020. Vol. 371. P. m3773. doi: 10.1136/bmj.m3773

[51] Trabert B, Coburn SB, Mariani A, et al. Reported Incidence and Survival of Fallopian Tube Carcinomas: A Population Based Analysis From the North American Association of Central Cancer Registries. J Natl Cancer Inst. 2018;110(7):750–757. doi: 10.1093/jnci/djx263

[52] Trabert B., Coburn S., Mariani A., et al. Reported Incidence and Survival of Fallopian Tube Carcinomas: A Population Based Analysis From the North American Association of Central Cancer Registries // J Natl Cancer Inst. 2018. Vol. 110. N 7. P. 750–757. doi: 10.1093/jnci/djx263

[53] Morozov SP, Lindenbraten LD, Gabai PG, et al. Osnovy menedzhmenta meditsinskoi vizualizatsii. Moscow: GEOTAR-Media, 2020. 432 p. EDN: ZRGBGE doi: 10.33029/9704-5247-9-MEN-2020-1-424

[54] Морозов С.П., Линденбратен Л.Д., Габай П.Г., и др. Основы менеджмента медицинской визуализации. М.: ГЭОТАР-Медиа, 2020. 432 с. EDN: ZRGBGE doi: 10.33029/9704-5247-9-MEN-2020-1-424

[55] Svidetelstvo o gosudarstvennoi registratsii programmy dlya EVM № 2024618494. Rossiiskaya Federatsiya. Platforma testirovaniya i obucheniya vrachei: № 2024617367. Vasilev YuA, Shulkin IM, Arzamasov KM, et al. Nauchno prakticheskii klinicheskii tsentr diagnostiki i telemeditsinskikh tekhnologii. (In Russ.) EDN: POELJA

[56] Свидетельство о государственной регистрации программы для ЭВМ № 2024618494 Российская Федерация. Платформа тестирования и обучения врачей: № 2024617367: заявл. 08.04.2024: опубл. 12.04.2024 / Ю.А. Васильев, И.М. Шулькин, К.М. Арзамасов, и др. ГБУЗ г. Москвы «Научно-практический клинический центр диагностики и телемедицинских технологий Департамента здравоохранения города Москвы». EDN: POELJA

Funding

Moscow City Health DepartmentДепартамент здравоохранения города МосквыMoscow City Health Department(123031400009-1)

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