Kuboya Takuya, Kato Kaoru, Sasaki Junichi
Department of Obstetrics and Gynecology, Moriya Daiichi General Hospital, Moriya, Ibaraki, Japan.
Department of Obstetrics and Gynecology, Moriya Daiichi General Hospital, Moriya, Ibaraki, Japan.
Int J Surg Case Rep. 2025 Feb;127:110889. doi: 10.1016/j.ijscr.2025.110889. Epub 2025 Jan 13.
Fallopian tube cancer, particularly the carcinosarcoma subtype, is a rare malignancy posing diagnostic challenges.
Our patient was an 83-year-old, nulligravida woman, presented to our outpatient clinic with one month of pelvic pain. On examination, a pelvic mass was detected. MRI suggested a cystic tumor in the fallopian tube, and pyosalpinx was initially suspected. Laparoscopic surgery was performed. However, she was later diagnosed with carcinosarcoma of the fallopian tube, according to the pathological diagnosis. The disease rapidly recurred and metastasized, including the development of Port-Site Metastasis (PSM). The patient underwent PSM excision surgery based on her request, which contributed to her mental well-being.
Diagnosing fallopian tube cancer is difficult, and there is often a misdiagnosis risk during surgery, leading to potential errors in treatment. MRI can help identify fallopian tubal cancer, but its features can also resemble benign conditions. Factors like infertility and chronic inflammation can increase the suspicion of cancer. Preventive measures for PSM during laparoscopic surgery are crucial. While it's unclear if removing port-site metastases improves the prognosis, it may benefit the patient's mental health.
Our findings underscore the importance of considering the possibility of malignancy when treating tubal tumors. We should take preventive measures for PSM during laparoscopic surgery. PSM excision surgery could be an option to enhance patient's mental health.
输卵管癌,尤其是癌肉瘤亚型,是一种罕见的恶性肿瘤,带来了诊断挑战。
我们的患者是一位83岁、未孕的女性,因盆腔疼痛一个月前来我们的门诊就诊。检查时发现盆腔有肿物。磁共振成像(MRI)提示输卵管有一个囊性肿瘤,最初怀疑是输卵管积脓。进行了腹腔镜手术。然而,根据病理诊断,她后来被诊断为输卵管癌肉瘤。疾病迅速复发并转移,包括出现了穿刺孔转移(PSM)。患者根据自己的要求接受了PSM切除手术,这对她的心理健康有益。
诊断输卵管癌很困难,手术期间常常存在误诊风险,导致治疗中可能出现失误。MRI有助于识别输卵管癌,但它的特征也可能类似良性病变。不孕和慢性炎症等因素会增加患癌的怀疑。腹腔镜手术期间预防PSM的措施至关重要。虽然尚不清楚切除穿刺孔转移灶是否能改善预后,但这可能对患者的心理健康有益。
我们的研究结果强调了在治疗输卵管肿瘤时考虑恶性肿瘤可能性的重要性。我们应在腹腔镜手术期间对PSM采取预防措施。PSM切除手术可能是增强患者心理健康的一种选择。