FALLOPIAN-TUBE CARCINOMA - AN UNDER-RECOGNIZED PRIMARY NEOPLASM

It has been suggested that primary carcinoma of the fallopian tube may be more common than has previously been recorded. To investigate this possibility further a clinico-pathological study was undertaken at Th e Northern General Hospital, Sheffield. All cases undergoing primary s urgical treatment for ovarian cancer at this regional Gynaecological O ncology unit were reviewed by one pathologist. Between January 1994 an d October 1995, 36 new cases of epithelial ovarian cancer were diagnos ed at laparotomy. During this time period three women, all of whom liv ed in the local catchment area, had a diagnosis of primary fallopian t ube carcinoma established by accepted pathologic criteria. One case wa s an incidental finding at the time of hysterectomy for benign disease . Another presented as cervical lymphadenopathy, which contained metas tatic papillary serous carcinoma, subsequently demonstrated at operati on to be of tubal origin. Over a 22 month period the ratio of primary tubal to ovarian carcinoma in our surgical population was 10 times tha t predicted by national incidence figures. The manner of presentation of two of the cases of tubal carcinoma raises the possibility that in other circumstances they may not have been recorded as such. If primar y tubal carcinoma is under-reported, there may be implications to the nature of the procedure performed as surgical prophylaxis against ovar ian cancer.