Medical diligence uncovers fallopian tube cancer after abnormal Pap test

BMJ Case Rep. 2019 Jul 24;12(7):e229762. doi: 10.1136/bcr-2019-229762.

Abstract

The fallopian tube has received attention as an origin of high-grade pelvic malignancies. This is a case of bilateral fallopian tube cancer discovered after an abnormal Pap test. A 62-year-old woman with a history of one term delivery had atypical glandular cells on a Pap test. She had an unsatisfactory colposcopy and a normal transvaginal ultrasound. A loop electrode excision procedure and hysteroscopy with dilation and curettage revealed atypical glandular cells concentrated in floating balls. CA-125 was 10 U/mL. A robotic hysterectomy revealed histopathological stage IIIA serous carcinoma arising from both fallopian tubes. She received six cycles of carboplatin and paclitaxel. After chemotherapy, she has no evidence of disease at 5 years. Fallopian tube carcinoma is a differential diagnosis of abnormal glandular cells on a Pap test. Diagnosis by systematic pursuit of abnormal tests can lead to successful treatment of a small disease burden.

Keywords: cancer intervention; cervical screening; gynaecological cancer; obstetrics and gynaecology; screening (oncology).

Publication types

  • Case Reports

MeSH terms

  • Carcinoma, Transitional Cell / diagnosis*
  • Carcinoma, Transitional Cell / therapy
  • Drug Therapy
  • Epithelial Cells / pathology*
  • Fallopian Tube Neoplasms / diagnosis*
  • Fallopian Tube Neoplasms / therapy
  • Fallopian Tubes / pathology*
  • Female
  • Humans
  • Hysterectomy
  • Middle Aged
  • Papanicolaou Test*
  • Treatment Outcome