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finition/Description Tumors of the Fallopian tube are a rarely presenting cancer, highly aggressive, like tumors of the ovary, even though, thanks to a frequently earlier diagnosis, less dramatic in the figures of the overall survival. They are characterized by the presence of pain and bleeding even in a relatively early stage of the disease, which helps for an early disease detection. Treatment of choice is a surgical approach, followed, if negative prognostic factors are present, by chemotherapy. Radiotherapy is arguably used as adjuvant postsurgical treatment with indication criteria, treatment techniques, and risk for adverse events similar to those of ovarian cancer. As far as today, even if the available data are controversial, chemotherapy and radiotherapy must be taken into account as a valuable postsurgical approach in specific clinical and pathologic situations.
Anatomy The Fallopian tubes are hollow, muscular structures lying in the superior part of the broad ligament, extending from the correspondent ovary into the peritoneal cavity. They project outward, backward, and finally downward opening in the uterus corpus, communicating with the
endometrial cavity. The tubal wall consists of four layers: mucosa, submucosa, muscularis (external longitudinal and internal circular) and outer serosa, the latter continuous to the visceral uterine peritoneum. The mucosa is extremely folded, with an epithelium mainly composed of ciliated and secretory cells. Hormonal cycle impacts the tubal epithelium as it does with the uterus, due to the estro-progestinic stimuli. Most of the tubal malignancies arise from the epithelium, possibly somehow relating to the periodic hormonesinduced changes. Vascular supply derives from the ovarian artery, with anastomoses to the uterine artery. Venous drainage is through the pampiniform plexus to the ovarian vein. Lymphatic circulation drains into the ovarian lymphatics and lumbar lymphonodes. Para-aortic and iliac nodes may be infected directly from the lymphatic network of the mucosa.
Epidemiology Cancer of the Fallopian tube is the rarest female genital tract malignancy; only 1,500 cases have been so far reported in the medical literature. They account for 0.15–1.8% of all gynecological malignancies, averaging 0.3% (Hanton et al. 1990), with a higher prevalence in white than in black women (Rosenblatt et al. 1989). The age range of this disease has been reported as wide as 18–87 years, with a peak of incidence in the fifth and sixth decades of life. Patients with Fallopian tube cancer tend to be women with a low parity rate, and more frequently in postmenopause (Nordin 1994).
L.W. Brady, T.E. Yaeger (eds.), Encyclopedia of Radiation Oncology, DOI 10.1007/978-3-540-85516-3, # Springer-Verlag Berlin Heidelberg 2013
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Fallopian Tube
Clinical Presentation Several symptoms and signs, sometimes in an early phase of the disease, characterize Fallopian tubes cancers. Classically, triad of pelvic pain, pelvic mass, and leucorrhea or the other one consisting of vaginal bleeding, vag
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