Benign tumors of fallopian tubes are rare and originate from accessory mesonephros or mesonephros. Tumors that can occur in uterus can occur in fallopian tubes, so there are many kinds. Among them, adenomatoid tumors are more common, while others such as adenoma, hemangioma, leiomyoma, lipoma and teratoma are less common. Because the tumor is small and asymptomatic. Preoperative diagnosis is difficult and prognosis is good.

There are two kinds of malignant tumors of fallopian tubes: primary and secondary. Most of them are secondary cancers, accounting for 80 ~ 90% of tubal malignant tumors. Most primary tumors are located in ovarian endometrium, and they can also come from contralateral fallopian tubes or cancers of breast and gastrointestinal tract. The main ways of metastasis are direct dissemination and lymphatic metastasis. The lesion first invades the serosa layer of fallopian tube, and its tissue morphology is the same as that of the primary lesion. Symptoms, signs and treatment depend on the primary focus and the prognosis is poor.

Primary carcinoma of fallopian tube is a rare malignant tumor of female reproductive tract, and its incidence is only 0.5% of gynecological malignant tumor. The average age of onset is 52 years old, mostly after menopause.

The cause of disease

The reasons for it were not known 70% of patients have chronic salpingitis, and 50% have a history of infertility. It is concluded that chronic inflammatory stimulation may be the cause of the disease. Although chronic salpingitis is common, patients with salpingitis are rare. Even if inflammation is related to the onset, it is not an inducement.

pathological change

1, pathological examination is mostly unilateral, bilateral rare, mostly occurring in ampulla of fallopian tube. The lesion originated from the fallopian tube endometrium, and the serosa surface was rough and adhered to the surrounding tissues. At the early stage, it was nodular, and with the progress of the disease, the fallopian tube became thicker like sausage. About 50% patients have the umbrella-shaped end obstruction of fallopian tube, which is difficult to distinguish from hydrosalpinx, hematocele or pus. The section shows that the lumen of fallopian tube is enlarged, the wall is thin, and the lumen is full of gray-white or cauliflower-like vegetation, often accompanied by infection, necrosis and dark brown turbid liquid. Microscopically, most of them are adenocarcinoma, which can be divided into three grades according to the differentiation degree and tissue structure of cancer cells: grade ⅰ is type *, with low malignancy; Type ⅱ is * acinar type with high degree of malignancy; Type ⅲ is acinar medullary type with high degree of malignancy.

Step 2 transfer the route

(1) Direct difference: the main transfer route. The open umbrella end is implanted on the surface of peritoneum, omentum or intestine. It can also involve uterine body, cervix and contralateral fallopian tube along mucosal growth.

(2) Lymphatic metastasis: it can spread to peritoneum, omentum, ovary, uterus, common iliac lymph or lymph nodes near abdominal aorta, and a few can involve supraclavicular and inguinal lymph nodes.

(3) Hematogenous metastasis: it can invade liver, lung, vagina and bone, but it is rare.

3. According to the pathological results of preoperative tumor shrinkage, determine the stages of tubal cancer, and adopt FIGO(2000) standard:

Stage 0: carcinoma in situ (before invasion)

Stage 1: Cancer is confined to fallopian tubes.

Stage ⅰ a: the cancer was confined to one fallopian tube without serosa perforation; Ascites free

Stage ⅰ b: the cancer was confined to bilateral fallopian tubes without serosa perforation; Ascites free

Stage ⅰ c: stage ⅰ a or ⅰ b when the cancer reaches or penetrates the serosa; Or ascites or peritoneal lavage contains cancer cells.

Stage Ⅱ: Unilateral or bilateral fallopian tube carcinoma with pelvic diffusion.

Stage Ⅱ A: Cancer spreads or metastasizes to uterus and ovary.

Stage Ⅱ b: Cancer cells spread to other pelvic tissues.

Stage ⅱC: pelvic diffusion (stage ⅱA and ⅱB) with ascites or peritoneal lavage containing cancer cells.

Stage Ⅲ: Unilateral or bilateral fallopian tube carcinoma with extrapelvic metastasis and/or regional metastasis. Or the cancer is confined to the pelvic cavity, but the small intestine or omentum metastasis can be seen under the microscope.

Stage Ⅲ a: Abdominal metastasis can be seen under microscope.

Ⅲ b stage: the diameter of abdominal metastasis was less than 2 cm by naked eye observation.

Ⅲ c stage: abdominal cancer focus > 2 cm and/or regional lymph node metastasis.

Stage ⅳ: distant metastasis. Not including abdominal metastasis