Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah 84112, USA.
Int J Gynecol Pathol. 2011 Jan;30(1):53-7. doi: 10.1097/PGP.0b013e3181eb2f9b.
Serous carcinoma originating in the fallopian tube usually presents at an advanced stage with extensive pelvic disease. Palpable axillary lymphadenopathy as the initial presentation of primary fallopian tube cancer without extensive extratubal spread in the pelvis is very uncommon. We report a case of a woman with a high-grade serous carcinoma of fallopian tube origin whose initial clinical presentation was palpable axillary lymphadenopathy. On histopathologic evaluation of her primary tumor, only minimal extension to the ipsilateral ovary was identified, with no other pelvic involvement. No additional supradiaphragmatic involvement was identified on imaging. Although the primary route of spread of tubal cancer is primarily through the direct exfoliation of the cells onto the adjacent surfaces in the peritoneal cavity, less commonly, lymphatic spread can result in distant metastasis, preceding intraperitoneal extension.
原发于输卵管的浆液性癌通常在晚期出现，伴有广泛的盆腔疾病。可触及的腋窝淋巴结肿大作为原发性输卵管癌的初始表现，且盆腔内无广泛的附件外扩散是非常罕见的。我们报告了一例来源于输卵管的高级别浆液性癌患者，其初始临床表现为可触及的腋窝淋巴结肿大。对其原发性肿瘤的组织病理学评估仅发现同侧卵巢有轻微的延伸，无其他盆腔受累。影像学检查未发现其他膈上受累。尽管输卵管癌的主要扩散途径主要是通过细胞直接脱落到腹膜腔的邻近表面，但较少见的是，淋巴扩散可导致远处转移，先于腹腔内扩散。
