Department of Obstetrics and Gynecology, Osaka Medical and Pharmaceutical University, 2-7 Daigakumachi, Takatsuki, Osaka, 569-8686, Japan.
Department of Pathology, Osaka Medical and Pharmaceutical University, 2-7 Daigakumachi, Takatsuki, Osaka, 569-8686, Japan.
J Med Case Rep. 2023 Aug 18;17(1):351. doi: 10.1186/s13256-023-04095-6.
At the time of benign gynecological surgery, a prophylactic salpingo-oophorectomy or salpingectomy is increasingly being performed concurrently to reduce the risk of future ovarian and fallopian tube cancer. We herein describe a case of hereditary breast and ovarian cancer syndrome in which a hysterectomy and bilateral adnexectomy were performed with a preoperative diagnosis of benign tumor. A detailed pathological examination revealed occult fallopian tube cancer, and additional staging surgery provided an accurate pathology diagnosis.
A 72-year-old Japanese woman with a past history of breast cancer underwent a hysterectomy and bilateral oophoro-salpingectomy for the preoperative diagnosis of uterine myoma and a right para-ovarian cyst. In the detailed pathological examination, high-grade serous carcinoma of the right fallopian tube was detected incidentally, and a subsequent staging laparotomy confirmed single para-aortic lymph node metastasis. Furthermore, a mutation in germline BRCA2 was detected postoperatively, and the patient was finally diagnosed with hereditary breast and ovarian cancer syndrome. She was diagnosed with fallopian tube cancer International Federation of Gynecology and Obstetrics Stage IIIA1(i) and started on adjuvant therapy (six courses of paclitaxel and carboplatin followed by maintenance therapy with olaparib), and 18 months after surgery, she was free of disease.
This is a case of fallopian tube cancer that was diagnosed incidentally and then accurately staged with additional advanced staging surgery. Even in the absence of grossly malignant findings, a detailed pathological search of the fallopian tubes and accurate staging surgery are important to make the necessary treatment decisions for the patient.
在进行良性妇科手术时，越来越多地同时进行预防性输卵管卵巢切除术或输卵管切除术，以降低未来卵巢和输卵管癌的风险。本文描述了一例遗传性乳腺癌和卵巢癌综合征病例，该患者术前诊断为良性肿瘤，行子宫切除术和双侧附件切除术。详细的病理检查显示隐匿性输卵管癌，并进行了进一步的分期手术以提供准确的病理诊断。
一名 72 岁日本女性，既往有乳腺癌病史，因术前诊断为子宫肌瘤和右侧附件囊肿而行子宫切除术和双侧卵巢输卵管切除术。在详细的病理检查中，意外发现右侧输卵管高级别浆液性腺癌，随后进行分期剖腹手术证实存在单一腹膜后淋巴结转移。此外，术后检测到胚系 BRCA2 突变，最终诊断为遗传性乳腺癌和卵巢癌综合征。患者被诊断为输卵管癌国际妇产科联合会（FIGO）分期 IIIA1(i)，开始接受辅助治疗（紫杉醇和卡铂 6 个疗程，随后奥拉帕利维持治疗），术后 18 个月，患者无疾病。
这是一例偶然诊断出的输卵管癌，然后通过进一步的高级别分期手术进行了准确分期。即使没有明显的恶性发现，对输卵管进行详细的病理检查和准确的分期手术对于为患者做出必要的治疗决策非常重要。
