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Fallopian Tube Cancer Fallopian tube cancer is usually adenocarcinoma, manifesting as an adnexal mass or as vague symptoms. Diagnosis, staging, and treatment are surgical. Primary fallopian tube cancer is rare. Average age at diagnosis is 50 to 60. Risk factors include chronic salpingitis, other inflammatory disorders (eg, TB), and infertility. Most (> 95%) fallopian tube cancers are papillary serous adenocarcinomas; a few are sarcomas. Spread, like that of ovarian cancer, is by direct extension, by peritoneal seeding, or through the lymphatics. Most patients present with an adnexal mass or vague abdominal or pelvic symptoms (eg, abdominal discomfort, bloating, pain). A few patients present with hydrops tubae profluens (a triad of pelvic pain, copious watery discharge, and adnexal mass), which is more specific. Imaging is typically done with CT scan. A distended solid adnexal mass and normal ovaries suggest fallopian tube cancer. If cancer is suspected, surgery is necessary for diagnosis, staging, and treatment. Staging (similar to that of ovarian cancer) requires washings from the pelvis, abdominal gutters, and diaphragmatic recesses; multiple pelvic and abdominal peritoneal biopsies; and pelvic and para-aortic lymph node dissection. Treatment includes total abdominal hysterectomy, bilateral salpingo-oophorectomy, and infracolic omentectomy. If cancer appears advanced, cytoreductive surgery is indicated. Postoperative treatment is identical to that for ovarian cancer. External beam radiation is rarely indicated.
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