抄録
We report a case of fallopian tube cancer diagnosed by laparoscopy. The patient was a 68-year-old woman who presented at a clinic with a chief complaint of irregular vaginal bleeding. She was found to have a slightly enlarged left ovary and a high serum CA546 level of 51 U/mL. Transvaginal ultrasonic tomography at the initial visit imaged a tumor measuring 3.5 cm x 3.4 cm in the left adnexa. An 18F-fluorodeoxyglucose (FDG) positron emission tomography scan detected an abnormal FDG accumulation located solely in the left adnexal tumor; the SUVmax was 9.2. Because the tumor was suspicious for malignancy, the patient underwent diagnostic laparoscopy; it revealed papillary tumor-like lesions in the swollen left fallopian tube and the left fimbria. An intraoperative diagnosis of left fallopian tube cancer was made, and the procedure was immediately converted to a laparotomy. After performing a total hysterectomy and bilateral salpingo-oophorectomy, cytological examination of the rapidly-frozen specimens revealed adenocarcinoma of the left adnexa. The procedure was then expanded to an omentectomy and a pelvic and para-aortic lymphadenectomy. The histopathologic diagnosis was primary serous adenocarcinoma of the left fallopian tube. The clinical stage of the patient's disease wasIIC (pT2cN0M0). The patient's postoperative course was good, and she was discharged on postoperative day 11. The patient received six courses of adjuvant chemotherapy in combination with paclitaxel and carboplatin. She is now two years postoperative with no signs of recurrence.
