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Fallopian Tube
Neoplasms
Chapter 47
Mitchell I. Edelson, MD
❍ What embryologic layer gives rise to the majority of benign tumors of the fallopian tube?
Mesoderm.
❍ What is a Walthard nest?
A benign inclusion cyst created in the fallopian tube by invagination of the tubal serosa. It is filled with polygonal
epithelial-like cells with distinctive, irregularly ovoid nuclei with longitudinal nuclear grooves that give them a
coffee-bean appearance. They are common incidental findings of no clinical importance.
❍ What is the most common benign tubal tumor?
Adenomatoid tumors (benign mesotheliomas). They appear as small (1–2 cm) nodular masses with multiple,
spherical, or slit-like channels lined by an attenuated layer of cells. There is no evidence of cytologic atypia.
❍ What is salpingitis isthmica nodosa and how is it differentiated from primary carcinoma of the fallopian tube?
Salpingitis isthmica nodosa is a localized diverticulosis of the isthmic portion of the fallopian tube. Grossly, it
appears as a firm, nodular dilatation of the isthmus with a diameter of <2 cm. Microscopically, the glandular
endosalpinx is seen extending from the lumen deep into the muscularis. It is differentiated from primary
carcinoma of the fallopian tube by its lack of cytologic atypia.
❍ What is the most common carcinoma that involves the fallopian tube?
Metastatic carcinomas from another site in the female genital tract. Almost 50% of women with ovarian cancer
and up to 12% of uterine cancers will have spread to the fallopian tube.
❍ What percentage of primary malignancies of the female genital tract arise from the fallopian tubes?
0.2% to 0.5%.
❍ What is the most common primary malignant neoplasm of the fallopian tube?
Papillary serous adenocarcinoma, accounting for 90% of all fallopian tube malignancies.
❍ Describe the classic triad of symptoms associated with fallopian tube malignancies.
Profuse clear or serosanguinous vaginal discharge (hydrops tubae profluens), pelvic pain, and a pelvic mass.