Fallopian tube tumors

　　The etiology of fallopian tube tumors is unknown. Infertility and few births may be the main risk factors. Up to 30% to 60% of fallopian tube cancer patients have a history of infertility. Inflammation may be a predisposing factor. The pathological examination of this disease shows the following characteristics:

　　1. Gross examination:Lesions are commonly found in the ampulla, followed by the fimbria. Most occur unilaterally, with bilateral cases accounting for 10% to 26%. Early fallopian tube cancer may appear normal, often presenting with the thickening of the fallopian tube in an irregular or sausagelike shape. The cross-section of the fallopian tube shows cauliflower-like tissue or necrotic masses within the lumen. The fimbria is often adherent and sealed with surrounding tissue, and there may be fluid, blood, or pus accumulation within the lumen.

　　2. Microscopic examination:The majority are papillary adenocarcinomas, accounting for 90%, among which 50% are serous carcinomas, most of which are poorly differentiated. Other less common types include endometrioid carcinoma, clear cell carcinoma, squamous cell carcinoma, acinar adenocarcinoma, adenosquamous carcinoma, and mucinous carcinoma. The histological classification of fallopian tube adenocarcinoma is divided into three grades: Grade I is papillary type, with good differentiation, mainly composed of papillary structures, and low malignancy; Grade II is papillary acinar type, with the papillary structure still present but with poor cell differentiation, obvious atypia, and the formation of small acini or glandular lumens; Grade III is acinar medullary type, with poor cell differentiation, high malignancy, numerous mitotic figures, and the formation of solid sheet-like or nest-like structures. Sometimes, acinar structures can be seen.

　　Fallopian tube tumors can cause harm to the isthmus, ampulla, and hydrosalpinx of the fallopian tube. If not relieved in time, it can lead to complications such as salpingitis, fallopian tube obstruction, infertility, and ectopic pregnancy.

　　Early symptoms of fallopian tube tumors are often absent or manifested as vaginal discharge, mild abdominal pain, etc. When the tumor grows to a certain extent, an abdominal mass can be found. If there is a large amount of watery excretion, bleeding, and abdominal pain, the condition is often in the middle or late stage; if the cancer cells spread widely, the vaginal discharge may be dark and foul-smelling, and there may also be symptoms such as difficulty in urination or intestinal obstruction.

　　1. Vaginal discharge:About 50% of patients have vaginal discharge, which is a yellow watery fluid, generally odorless, with varying amounts, often intermittent. This is the most specific symptom of the disease.

　　2. Vaginal bleeding:It often occurs in the middle of the menstrual period or after menopause, presenting as irregular, small amount of bleeding, and curettage is often negative.

　　3. Abdominal pain:It is usually dull pain in the lower abdomen on the affected side, caused by the enlargement of the fallopian tube. Sometimes it presents as intermittent colicky pain, caused by spasmodic contraction of the fallopian tube. After a large amount of fluid is discharged from the vagina, the pain is relieved accordingly. A few patients may experience severe abdominal pain, which is due to complications.

　　4. Lower abdominal mass:During gynecological examination, it is often possible to palpate one or both fallopian tubes thickened or masses. They are solid with a cystic sensation, in the shape of a sausage or irregular, with slight tenderness and limited mobility. The mass shrinks after discharge, and it becomes larger again after the fluid accumulates.

　　5. Ascites:Less common, with an incidence rate of about 10%, presenting as light yellow or bloody.

　　6. Other:Enlarged tumors that compress or involve surrounding organs can cause abdominal distension, frequent urination, urgency, and late-stage cachexia.

　　To prevent fallopian tube tumors, we can start from the following aspects:

　　1. Avoid unclean sexual intercourse and improper sexual relations; patients with active genital herpes should be strictly prohibited from having sexual relations with anyone.

　　2. Abstain from sexual intercourse during treatment, and the spouse should also be examined if necessary.

　　3. For the care of local lesions, attention should be paid to keep the area clean and dry to prevent secondary infection.

　　6. After cure or recurrence, attention should be paid to prevent colds, catching a chill, fatigue, and other triggering factors to reduce recurrence.

　　Fallopian tube tumors can be diagnosed by the following examinations:

　　1. Cytological examination:Atypical ciliated glandular cells are found in vaginal smear cytology, suggesting the possibility of fallopian tube cancer. Those with positive results should undergo fractional curettage to exclude endometrial cancer and cervical cancer. If the cytological examination is positive but the diagnostic curettage is negative, it may be fallopian tube cancer. When the tumor penetrates the serous membrane layer or spreads to the pelvic and abdominal cavity, malignant cells can be found in the ascites or abdominal lavage fluid.

　　2. Endometrial examination:Patients with endometrial cancer and submucosal leiomyoma often have vaginal discharge. To exclude these diseases, it is necessary to perform fractional curettage. The diagnostic curettage in patients with fallopian tube cancer is usually negative, except for those with intraperitoneal metastasis.

　　3. Imaging examination:B-ultrasound, CT, MRI, etc. are helpful for preoperative diagnosis and staging, and can determine the location, size, nature, and presence of ascites of the mass.

　　4. Serum CAl25 measurement:It can be an important reference index for the diagnosis and prognosis of fallopian tube cancer, but it is not specific.

　　5. Laparoscopic examination:Laparoscopy can directly observe the fallopian tube and ovary, which is helpful for the diagnosis of fallopian tube cancer, and at the same time, it can aspirate peritoneal fluid for cytological examination.

　　For different symptoms of tubal tumors, patients are recommended to consume the following foods:

　　1. Infection:Celery, eel, clam, sesame, buckwheat, rapeseed, toon, snake meat, red bean, mung bean, wheat, carp, etc.

　　2. Bleeding:Goat blood, shepherds purse, lotus root, mushrooms, malan head, stone ear, persimmon cake, garlic, snails, light fish, etc.

　　3. Tenderness and pain:Pork kidney, skate, myrica, hawthorn, tangerine cake, walnut, hickory, chestnut, etc.

　　Contraindications: Avoid smoking, alcohol, spicy and刺激性 foods, and high-fat diet.

　　The treatment of tubal tumors mainly focuses on surgery, with adjuvant chemotherapy and radiotherapy, emphasizing the thoroughness of the first treatment. Specifically as follows:

　　1. Surgical Treatment: The principle is to perform comprehensive staging surgery early and tumor cell reduction surgery in the late stage.

　　2. Chemotherapy: Similar to ovarian cancer, a combination chemotherapy regimen mainly consisting of platinum and paclitaxel is commonly used.

　　3. Radiotherapy: Due to the significant efficacy of platinum-based combination chemotherapy, radiotherapy is less commonly used.

　　In general, surgical treatment is the main treatment method, and it can be used for total hysterectomy, bilateral adnexectomy, and omentectomy. If the tumor has spread to the pelvis or abdomen, it is still necessary to strive for large resection of the tumor. It is generally not recommended to perform pelvic lymphadenectomy.