Fallopian tubes & broad ligament

Fallopian tube epithelial tumors

Endometrioid adenocarcinoma

Last author update: 1 September 2013
Last staff update: 16 June 2022

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PubMed Search: Endometrioid adenocarcinoma

Nat Pernick, M.D.
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Cite this page: Pernick N. Endometrioid adenocarcinoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/fallopiantubescarcinoma.html. Accessed September 27th, 2023.
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
Clinical features
  • 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)
  • Carcinomas at this site: 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

AFIP images
Diffusely enlarged tube

Diffusely enlarged tube

Papillary tumor attached to mucosa

Papillary tumor attached to mucosa

Lumen distended by solid tumor

Lumen distended by solid tumor

Distended, opened tube

Distended, opened tube

Microscopic (histologic) description
  • 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

AFIP images
Tumor arising in endometriosis

Tumor arising in endometriosis

Tumor simulating Wolffian adnexal tumor Tumor simulating Wolffian adnexal tumor Tumor simulating Wolffian adnexal tumor

Tumor simulating Wolffian adnexal tumor

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