| Primary fallopian tube carcinoma (PFTC) is a rare kind of gynecological tumor with an incidence of 0.14%—1.8% of all gynecological malignancies. It mainly occurred in postmenopausal women. Intermittent vaginal discharge, abdominal pain and pelvic mass is the typical clinical manifestations, which is known as Latzko's triad of symptoms, but only represented in 15% of cases. PFTC is easy to be confused with other gynecological diseases because most patients have atypical clinical features. At present PFTC can be diagnosed through the following examination:imaging (transvaginal ultrasound, CT, MRI),CA125 level, cytology, hysteroscopy and curettage. But there are no specific examination methods and tumor markers, so that it has high rate of misdiagnosis, which is up to 94-98% in our country. To analyze the reasons of fallopian tube cancer misdiagnosis is an important method of improving the diagnostic accuracy. Furthermore, it provides a big advantage of giving the patients correct and timely treatment and increasing the survival rate of the patients.ObjectiveA total of 41 cases with PFTC diagnosed from August 2000 to September 2010, reported from the Second Hospital of Jilin University have been retrospectively analyzed. And a detailed clinical manifestations and results of laboratory examinations have been described. In case of that, the results of its misdiagnosis are classified and the causes of misdiagnosis have been further analyzed. We hope the thesis will provide a favorable basis for the clinic work to improve the diagnosis rate of PFTC and the survival rate.Methods A total of 41 cases with PFTC diagnosed from August 2000 to September 2010, reported from the Second Hospital of Jilin University have been retrospectively analyzed. Date are presented by age, gravidity, parity, history, clinical manifestations, examinations, stage, surgery, pathology, diagnosis rate.ResultsOnly one case of 41 patients with PFTC has been correctly diagnosed before operation. However, it has 40 cases of misdiagnoses which with rate of 97.56%.19 cases were misdiagnosed as ovarian cancer with rate of 46.34%,15 cases as ovarian benign tumor with rate of 36.59%,4 cases as endometrial carcinoma with rate of 9.75%,1 case as uterine fibroids with rate of 2.44%,1 case as no definite diagnosis before the surgery with rate of 2.44%.Conclusion(1)The anatomical location of the fallopian tube is very close to that of the ovary. And it is a very common phenomenon of invasion between the two organs when one of them has got a carcinoma. PFTC is always neglected because it is a rare gynecological tumor with a low incidence, which is the main reason for the high rate of misdiagnosis.(2)50-60 years old women, especially postmenopausal ones, is a high risk of primary fallopian tube carcinoma.(3)There are few of patients with the typical manifestation of trilogy of PFTC and most PFTC patients have no specificity in Clinical manifestation so that PFTC is easy to be confused with other gynecological diseases and it is difficult to correctly diagnose before the operation. Due to atypical clinical features, the misdiagnosis before the operation is sometimes unavoidable.(4) The imaging examinations, especially the transvaginal ultrasound, are the main diagnosis methods. But the color Doppler ultrasound has a low resolution in the tumor of the two organs and it is hard to tell the origin of the tumor from the result of the color Doppler ultrasound. Therefore, the color Doppler ultrasound has limited contribution on the diagnosis of the PFTC.(5)When postmenopausal women come out colporrhagia and pelvic mass, besides diagnostic curettage appears cancer cells, not only endometrial cancer needs to be considered, the possibilities of the transfer of cancer from fallopian tube to uterus also need to be considered.(6) CA125 can be used as a tumor marker.CA125 indwells in serosal epithelium and the tumor from Mullerian duct derivatives. When the amount of CA125 increasing, not only epithelial tumor of ovary needs to be associated, the possibility of PFTC should also be taken care.(7) Analysis of the causes of misdiagnosis and keeping vigilance on PFTC act as effective ways to reduce the misdiagnosis rate and improve the survival rate and the prognosis.
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