Yan Dan, Shen Chunfang, Ru Rongrong, Xu Huijing
Dan Yan Department of Ultrasound, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou 311202, China.
Chunfang Shen Department of Obstetrics and Gynecology, Hangzhou 311202, China. Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou 311202, China.
Pak J Med Sci. 2025 May;41(5):1511-1516. doi: 10.12669/pjms.41.5.10600.
This study retrospectively analyzed the ultrasound characteristics of primary fallopian tube carcinoma (PFTC) and the misdiagnosis and missed diagnosis.
Data of 15 PFTC patients undergoing surgical treatment in Affiliated Xiaoshan Hospital, Hangzhou Normal University from August 2013 to September 2022 were collected. The clinical features, ultrasound characteristics, pathological diagnosis results and misdiagnosis and missed diagnosis by ultrasound were analyzed.
In 15 patients, there were 8 (53.33%) cases with vaginal bleeding, 6 (40.00%) cases with abdominal pain, five (33.33%) cases with pelvic mass, and two (13.33%) cases with vaginal discharge. There were 11 (73.33%) cases with CA125 level ≥ 35 U/ml. In 15 patients, 10 cases presented a sausage-shaped mass in adnexal region (type I PFTC) (two cases of cystic mass with papillary nodules, three cases of cystic-solid mass, five cases of hypoechoic or heterogeneous hypoechoic solid mass), four cases presented irregular hypoechoic mass in adnexal region (type II PFTC), and one case did not present the mass (type III PFTC). In 15 patients, three cases were accompanied by hydrosalpinx, two cases were accompanied by uterine fluid accumulation, and five cases were accompanied by abdominal or pelvic fluid accumulation. There were totally seven (46.66%) cases misdiagnosed or missed of diagnosis by ultrasound.
The clinical manifestations of PFTC are diverse and lack of specificity. The ultrasound examination may have the misdiagnosis and missed diagnosis. PFTC should be highly suspected when there are characteristic ultrasound images including sausage-shaped mass companied by hydrosalpinx, uterine fluid accumulation, or abdominal or pelvic fluid accumulation. If the mass is small, it is prone to missed diagnosis.
本研究回顾性分析原发性输卵管癌（PFTC）的超声特征以及误诊和漏诊情况。
收集2013年8月至2022年9月在杭州师范大学附属萧山医院接受手术治疗的15例PFTC患者的数据。分析其临床特征、超声特征、病理诊断结果以及超声误诊和漏诊情况。
15例患者中，有8例（53.33%）出现阴道流血，6例（40.00%）出现腹痛，5例（33.33%）出现盆腔肿块，2例（13.33%）出现阴道分泌物。11例（73.33%）患者CA125水平≥35 U/ml。15例患者中，10例在附件区呈现腊肠样肿块（I型PFTC）（2例为伴有乳头状结节的囊性肿块，3例为囊实性肿块，5例为低回声或不均匀低回声实性肿块），4例在附件区呈现不规则低回声肿块（II型PFTC），1例未出现肿块（III型PFTC）。15例患者中，3例伴有输卵管积水，2例伴有子宫积液，5例伴有腹腔或盆腔积液。超声检查共有7例（46.66%）误诊或漏诊。
PFTC的临床表现多样且缺乏特异性。超声检查可能存在误诊和漏诊。当出现包括腊肠样肿块伴输卵管积水、子宫积液或腹腔或盆腔积液等特征性超声图像时，应高度怀疑PFTC。若肿块较小，则容易漏诊。
