Fallopian tubes

Author: Nat Pernick, M.D. (see Authors page)

Revised: 28 August 2017, last major update September 2013

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: Fallopian tube carcinoma[title]

Related topic: In situ carcinoma
Cite this page: Pernick, N. Carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/fallopiantubescarcinoma.html. Accessed June 22nd, 2018.
Definition / general
  • Rare, 0.3 to 1.0% of genital tract malignancies
  • Mean age 57 years, rarely teenagers; usually incorrect preoperative diagnosis
  • High stage with pelvic extension or positive peritoneal cytology
  • To call primary in fallopian tube, should arise from mucosa (endosalpinx), have tubal histologic pattern, involve the lumen, uterus and ovaries must be normal or have foci of malignancy that resemble metastases or independent primaries; if tubal wall is involved, should detect a transition between benign and malignant tubal epithelium
  • 5 year survival: stage 1 - 77%, stage 3 - 20%; usually recur intra-abdominally
  • Associated with BRCA1 and BRCA2 mutations; for patients with known mutation or family history of breast or ovarian cancer, should submit entire fallopian tube and ovary for microscopic examination (Am J Surg Pathol 2002;26:171, Am J Surg Pathol 2001;25:1283)
  • 50% serous, 25% endometrioid, 20% transitional or undifferentiated
  • Symptoms: vaginal bleeding or discharge (2/3), pain, adnexal mass (triad in 50%); endometrial smear positive in 10%
Gross description
  • Enlarged tube, with solid or papillary tumor filling the lumen
  • Tumors occasionally are primary in the fimbriae
  • 80 - 97% unilateral; hemorrhage, necrosis and cysts common
Gross images

Images hosted on PathOut server:

Various images

Microscopic (histologic) description
  • Invasive papillary adenocarcinoma; may resemble ovarian serous adenocarcinoma with complex papillary architecture
  • Endometrioid tumors may be noninvasive, have squamous metaplasia, be associated with endometriosis and contain spindled epithelial cells
  • May have small, closely packed cells with numerous glandular spaces of varying sizes, containing PAS+ dense colloid-like secretion, resembling female adnexal tumor of probable Wolffian origin (FATWO), but usually intraluminal, typical endometrioid carcinoma elsewhere, more mitotic activity and atypia, mucin present
Microscopic (histologic) images

Images hosted on PathOut server:

Endometrioid carcinoma:

Tumor arising in endometriosis

Tumor simulating Wolffian adnexal tumor

Serous papillary adenocarcinoma:

Lumen filled with fine
papillae lined by
neoplastic epithelial

Psammoma bodies and
desmoplastic stromal response
due to carcinoma invasion
in tubal wall

Undifferentiated component in
tubal wall contains
solid islands of
neoplastic epithelial cells