Fallopian tube cancer triad
Introduction
Introduction to triple fallopian tube cancer Fallopian tube cancer is highly malignant and difficult to diagnose early. Clinically, it often manifests as vaginal discharge, abdominal pain, and pelvic mass, which is called triad of fallopian tube cancer. basic knowledge Sickness ratio: 0.0001% Susceptible people: women Mode of infection: non-infectious Complications: uterine empyema, tubal adhesions
Cause
The cause of tubal cancer triad
(1) Causes of the disease
The cause is not fully understood. Patients are often accompanied by chronic salpingitis. It has been reported that the disease coexists with tubal tuberculosis, and also occurs after tubal ligation.
(two) pathogenesis
The pathological changes of primary fallopian tube cancer are as follows:
1. The local fallopian tube epithelium is replaced by cancer tissue.
2. The cancer tissue is confined to the fallopian tube, the oviduct muscle layer, the oviduct mesenteric lymphatic tube and the fallopian tube serosa are less invaded, even if there is invasion, the mucosa is lighter. Most of the primary fallopian tube cancer tissue stays in the submucosa and The luminal cavity protrudes and invades the muscle layer for a long time, and the metastatic fallopian tube cancer can find the lesion of the muscle wall at an early stage.
3. Although the cancer cells are not cilia, the structure is similar to that of the fallopian tube epithelium.
4. Endometrial and ovarian cancer-free foci, if the tumor is small, the histological examination can be seen to meet the cancer metastasis transferred by the fallopian tube.
5. The initial carcinogenesis of primary fallopian tube cancer can find the transitional morphology from normal epithelium to cancerous epithelium.
Whether bilateral fallopian tube cancer is a primary or secondary problem: bilateral fallopian tube cancer is evolved from the middle renal tube (the secondary kidney tube), and under the same carcinogenic factors, cancer can occur at the same time. Therefore, bilateral Fallopian tube cancer is considered to be primary fallopian tube cancer.
Fallopian tube adenocarcinoma with endometrial adenocarcinoma is primary or secondary problem: 1 If both lesions are earlier, no metastasis possibility, both should be primary; 2 metastatic lesions are endometrial presentation The focal invasion of the interstitial or superficial is often oppressive to the surrounding tissue, with no transitional morphology.
Prevention
Fallopian tube cancer triad prevention
1. Prevent infection and timely treat related diseases to reduce the malignant stimulation of the fallopian tubes.
2, garlic can reduce the risk of female fallopian tube cancer.
3. Pay attention to personal hygiene and strengthen menstrual protection.
4. Reject multiple sexual partners to avoid the spread of sexually transmitted diseases.
5, early detection of treatment, close follow-up.
Complication
Fallopian tube cancer triad complications Complications, uterine empyema, tubal adhesions
Adhesion of the surrounding tissues causes empyema and hemorrhage.
Symptom
Symptoms of fallopian tube cancer triad Symptoms Common symptoms Dull pain lower abdominal mass vaginal discharge is black watery ascites pelvic mass lower abdominal pain abdominal pain uterine bleeding
Clinically, it often manifests as vaginal discharge, abdominal pain, and pelvic mass, which is called triad of fallopian tube cancer.
1. Vaginal drainage or bleeding vaginal discharge is the most common symptom of fallopian tube cancer, but the fluid discharge is different, more or less, the discharge is serous yellow water, sometimes bloody, which is the process of cancer growth. The resulting exudate, generally no odor, can cause vaginal bleeding when the fallopian tube cancer is necrotic or infiltrating.
2. The lower abdomen pain occurs mostly on the affected side, which is dull pain. After a period of time, it gradually intensifies and becomes convulsive colic. If the vaginal discharges water or bloody liquid, the pain is relieved, and the possible mechanism is to develop in cancer. During the process, the lumen and the umbrella end are blocked by the tumor, the contents of the oviduct cavity are increased, the internal pressure is increased, and the tubal peristalsis is increased, and the effusion is discharged to overcome the obstruction of the fallopian tube.
3. The abdominal mass part of the patient can lick the lower abdomen mass, gynecological examination can be licked and lumps, the tumor can be the cancer itself, or concurrent with hydrosalpinx or uterine fibroids, etc., the small mass 3 ~ 4cm, the larger flat umbilical, solid or cystic, most of the surface is smooth, limited or fixed.
Other manifestations of fallopian tube cancer
(1) Ascites: Fallopian tube cancer is associated with ascites. The spread of fallopian tube cancer is similar to that of ovarian cancer. However, ascites is rare, and the growth of fallopian tube cancer may start from the luminal, while ovarian cancer begins. It occurs on the surface of the ovary.
(2) Spilled fallopian tube effusion: Latzko described the patient's symptoms in 1915 - pain relief, mass disappeared, accompanied by massive vaginal discharge, when the lumen was blocked by the tumor, secretions were deposited to a certain extent, internal pressure rise High can suddenly cause a large amount of vaginal discharge, the pressure in the lumen is reduced, the abdominal pain is reduced, and the mass is reduced. Therefore, this change process is characterized by fallopian tube cancer.
(3) Infertility: 1/3 to 1/2 patients with fallopian tube cancer have a history of primary or secondary infertility.
It is very malignant.
Examine
Examination of tubal cancer triad
Tumor marker examination, diagnostic curettage, vaginal exfoliation cell examination, laparoscopy, B-ultrasound, CT and other examinations.
Histopathological examination.
Diagnosis
Diagnosis and diagnosis of fallopian tube cancer triad
diagnosis
Patients with fallopian tube cancer should be considered if:
1. There are three characteristics of vaginal discharge, abdominal pain, and abdominal block.
2. There are persistent irregular uterine bleeding that cannot be explained, especially in the 35-year-old, cytology smear negative and negative for endometrial pathology.
3. There is persistent abnormal bloody vaginal discharge that cannot be explained. The patient is >35 years old.
4. There is persistent pain in the lower abdomen and/or lower back that cannot be explained.
5. Abnormal adenocarcinoma cells appear in the cervical smear.
6. Attachment lumps were found before and after menopause.
Differential diagnosis
Mainly should be differentiated from ovarian cancer and endometrial cancer.
