A case of stage ⅣB fallopian tube carcinoma with myometrial metastasis, in which endometrial cytology was useful for diagnosing the site of the primary tumor

Abstract

Background : In patients with fallopian tube carcinoma, cancer cells can be detected on endometrial cytology.

Case : The patient was a 56-year-old woman who presented with massive ascites and parasternal lymphadenopathy and masses in the peritoneum, left ovary, and uterine corpus. Findings of endometrial cytology suggested ovarian, fallopian tube, or peritoneal cancer rather than endometrial cancer. After administering two courses of chemotherapy, we performed laparoscopic bilateral salpingo-oophorectomy and hysteroscopic biopsy of the endometrium and myometrium. Postoperative histopathology revealed serous tubal intraepithelial carcinoma in the right fallopian tube. Endometrial histopathology revealed small clusters of adenocarcinoma cells not contiguous with the normal endometrium, which suggested metastasis to the myometrium. We administered four additional courses of chemotherapy, followed by hysterectomy and omentectomy. Postoperative histopathology revealed high-grade serous carcinoma in the myometrium and omentum, but no tumor cells in the endometrium. The final histopathological diagnosis was stage ⅣB right fallopian tube carcinoma with myometrial metastasis.

Conclusion : Endometrial cytology revealing small clusters of atypical cells with normal endometrial cells in a normal background should raise the suspicion of fallopian tube carcinoma.