Malignant Lesions of the Fallopian Tube and Broad Ligament 

  • Author: Hetal B Gor, MD, FACOG; Chief Editor: Warner K Huh, MD   more...
 
Updated: Feb 11, 2011
 

Background

In 1847, Renaud first described fallopian tube malignancy. In 1888, Orthmann submitted the first genuine case report.[1]

The broad ligament is a double fold of peritoneum, which is formed by the reflection of the peritoneum off the pelvic floor and the lateral pelvic wall. Most tumors are benign cysts, but malignant tumors are categorized as either primary or secondary.

Primary malignancies of the broad ligament include those of müllerian origin (ie, serous carcinoma, papillary carcinoma, cystadenocarcinoma, endometrioid carcinoma, clear cell carcinoma), urothelium transitional cell carcinoma, mesenchymal sarcoma or histiocytoma, and pheochromocytoma. Some researchers suggest that some primary fallopian tube cancers are misdiagnosed as primary ovarian cancers; however, an experienced pathologist can help to differentiate that.

Secondary malignancies of the broad ligament include metastatic cancers from endometrial, cervical, and ovarian carcinoma.

A primary malignancy is diagnosed based on its location within or on the surface of the broad ligament and by virtue of the complete separation of the tumor from the uterus and ovaries.

See also eMedicine articles Fallopian Tube Disorders and Broad Ligament Disorders.

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Pathophysiology

Fallopian tube malignancy usually starts as a dysplasia or carcinoma in situ. Typically, transition to adenocarcinoma is observed.

The etiology of malignancies of the broad ligament is unknown, although they are associated with endometriosis.

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Epidemiology

Frequency

United States

Fallopian tube carcinomas comprise 1% of all gynecologic cancers. The average annual incidence is 3.6 cases per million women.

Mortality/Morbidity

On average, the 5-year survival rate is 51%; the rate for stage I disease is 65%, stage II disease is 50-60%, and stage III and stage IV disease is 10-20%.

Race

These lesions are more common in whites.

Age

Incidence increases with age but peaks at 60-66 years.

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Contributor Information and Disclosures
Author

Hetal B Gor, MD, FACOG  Obstetrician/Gynecologist, Private Practice

Hetal B Gor, MD, FACOG is a member of the following medical societies: American College of Obstetricians and Gynecologists and Society of Laparoendoscopic Surgeons

Disclosure: Nothing to disclose.

Coauthor(s)

John Paulson, MD  Clinical Professor of Obstetrics/Gynecology, Eastern Virginia Medical School; Professor of Clinical Obstetrics/Gynecology, Medical College of Virginia; Associate Director, Residency Program, Riverside Health System

John Paulson, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists and International College of Surgeons US Section

Disclosure: Nothing to disclose.

Specialty Editor Board

Karen Loeb Lifford, MD  Director of General Gynecology, Associate Program Director, Department of Obstetrics and Gynecology, Instructor, Brigham and Women's Hospital, Harvard Medical School

Karen Loeb Lifford, MD is a member of the following medical societies: Association of Professors of Gynecology and Obstetrics, Massachusetts Medical Society, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Michel E Rivlin, MD  Professor, Coordinator of Quality Assurance/Quality Improvement, Department of Obstetrics and Gynecology, University of Mississippi School of Medicine

Michel E Rivlin, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Medical Association, Mississippi State Medical Association, and Royal College of Surgeons of Edinburgh

Disclosure: Nothing to disclose.

Frederick B Gaupp, MD  Consulting Staff, Department of Family Practice, Hancock Medical Center

Frederick B Gaupp, MD is a member of the following medical societies: American Academy of Family Physicians

Disclosure: Nothing to disclose.

Chief Editor

Warner K Huh, MD  Professor, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Senior Scientist, Comprehensive Cancer Center, University of Alabama School of Medicine

Warner K Huh, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American College of Surgeons, American Society of Clinical Oncology, Massachusetts Medical Society, and Society of Gynecologist Oncologists

Disclosure: MERCK Consulting fee Consulting; GSK Consulting fee Consulting; ROCHE PHARMA/DIAGNOSTICS Consulting fee Consulting; HOLOGICS Consulting fee Consulting; HELIX BIOPHARMA Consulting fee Consulting; COVIDIEN Consulting fee Consulting; INTUITIVE SURGICAL Surgical Proctor

References

  1. Orthmann EG. Primareskarzinom in Einertuberkulosen. Ztschr Geburtsh Gynaek. 1888;15:212.

  2. Kalir T, Rahaman J, Hagopian G, Demopoulos R, Cohen C, Burstein DE. Immunohistochemical detection of glucose transporter GLUT1 in benign and malignant fallopian tube epithelia, with comparison to ovarian carcinomas. Arch Pathol Lab Med. May 2005;129(5):651-4. [Medline].

  3. Alvarado-Cabrero I, Young RH, Vamvakas EC. Carcinoma of the fallopian tube: a clinicopathological study of 105 cases with observations on staging and prognostic factors. Gynecol Oncol. Mar 1999;72(3):367-79. [Medline].

  4. Aslani M, Scully RE. Primary carcinoma of the broad ligament. Report of four cases and review of the literature. Cancer. Oct 1 1989;64(7):1540-5. [Medline].

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  8. Dieste MC, Lynch GR, Gordon A. Malignant fibrous histiocytoma of the broad ligament: a case report and literature review. Gynecol Oncol. Oct 1987;28(2):225-9. [Medline].

  9. Disaia PJ, Creasman WT. Fallopian tube cancer. In: Creasman WT, Doherty M, Disaia PJ, Dinh TV, Hannigan EV, eds. Clinical Gynecologic Oncology. 5th ed. St. Louis, Mo: Mosby-Year Book; 1997:375-80.

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  12. Kurjak A, Kupesic S, Jacobs I. Preoperative diagnosis of the primary fallopian tube carcinoma by three- dimensional static and power Doppler sonography. Ultrasound Obstet Gynecol. Mar 2000;15(3):246-51. [Medline].

  13. Latner AL, Turner GA. Effect of aprotinin on immunological resistance in tumour-bearing animals. Br J Cancer. May 1976;33(5):535-8. [Medline].

  14. Loverro G, Cormio G, Renzulli G. Serous papillary cystadenoma of borderline malignancy of the broad ligament. Eur J Obstet Gynecol Reprod Biol. Aug 1997;74(2):211-3. [Medline].

  15. Navani SS, Alvarado-Cabrero I, Young RH. Endometrioid carcinoma of the fallopian tube: a clinicopathologic analysis of 26 cases. Gynecol Oncol. Dec 1996;63(3):371-8. [Medline].

  16. Ricci JV. One Hundred Years of Gynecology. Philadelphia, Pa: Blackiston; 1945.

  17. Rose PG, Shrigley R, Wiesner GL. Germline BRCA2 mutation in a patient with fallopian tube carcinoma: a case report. Gynecol Oncol. May 2000;77(2):319-20. [Medline].

  18. Rosen AC, Ausch C, Hafner E. A 15-year overview of management and prognosis in primary fallopian tube carcinoma. Austrian Cooperative Study Group for Fallopian Tube Carcinoma. Eur J Cancer. Oct 1998;34(11):1725-9. [Medline].

  19. Rosen AC, Ausch C, Klein M. p53 expression in fallopian tube carcinomas. Cancer Lett. Aug 1 2000;156(1):1-7. [Medline].

 
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