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Histopathology. 2012 May;60(6B):E106-14. doi: 10.1111/j.1365-2559.2012.04194.x. Epub 2012 Mar 6.

Fallopian tube metastases of non-gynaecological origin: a series of 20 cases emphasizing patterns of involvement including intra-epithelial spread.

Author information

1
Department of Pathology, King Edward Memorial Hospital, Perth, Western Australia, Australia. colin.stewart@health.wa.gov.au

Abstract

AIMS:

  To determine the frequency and distribution of Fallopian tube involvement in patients with ovarian metastases of non-gynaecological origin.

METHODS AND RESULTS:

  All Fallopian tube tissue was processed for histological examination in a consecutive series of 31 patients with ovarian metastases of non-gynaecological origin. The most common primary sites were appendix (n = 10) colon (n = 7), stomach (n = 6) and breast (n = 4). Twenty cases (65%) showed at least one type of tubal spread. Mural involvement was most common (14 cases) but serosal, intra-vascular, intra-epithelial and intra-lumenal spread were also identified in 12, 9, 8 and 11 cases respectively. Intra-epithelial involvement was restricted to the fimbrial epithelium and mimicked tubal carcinoma in situ (CIS) architecturally. Pagetoid invasion was noted in two of the cases.

CONCLUSIONS:

  The Fallopian tubes are commonly involved in patients who have neoplasms metastatic to the ovaries. Metastases may show a CIS-like pattern of intra-epithelial spread and therefore small serous CIS-type lesions may not represent proof of tubal tumour origin in patients who have high-stage pelvic serous carcinomas. The frequency of intra-lumenal tumour cells supports transtubal spread as a likely mechanism for mucosal involvement by metastatic tumours involving the lower genital tract.

[Indexed for MEDLINE]

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