Uncommon Becoming Common: Case Series of Primary Fallopian Tube Cancers

Primary fallopian tube cancer (PFTC) is rare with an incidence of only 1% of gynaecology cancers. However, reports are emerging that it might be more common than the historical figure. We retrospectively evaluated all women diagnosed with fallopian cancers between November 2010 and October 2011. Incidence of fallopian cancers was 3.6% (6/165) of gynaecological malignancies. 50% (n=3) presented with classical symptoms of pain and discharge. We suspected PFTC in 3 out of the 6 cases (50%) while the figure quoted in literature is only 10%. While majority of women with PFTC (>80%) have an elevated CA125 level, our cohort was different with only 2 among the 6 with raised CA125 levels. Primary surgery was done in 50% women (n=3) in our hospital while the rest were referred to tertiary gynaeoncology centre. 3 (50%) have been diagnosed as having early stage disease and 3 (50%) as advanced cancer. Our case series shows the difficulty in correlating clinic-radiological findings, misleading CA125 levels of PFTC, leading to primary surgery being done by general gynaecologists rather than gyne-oncologists. A multi-disciplinary approach is advised with low index of suspicion in postmenopausal women presenting with adnexal pain. We believe our cohort had a higher rate of preoperative diagnosis because of the use of MRI in evaluation of adnexal masses.