J Gynecol Oncol.  2013 Apr;24(2):114-119. 10.3802/jgo.2013.24.2.114.

Microscopic lesions of fallopian tubes in endometrioid carcinoma of the endometrium: How effective are the macroscopic tubal sampling techniques?

• Kulac I
• Usubutun A

• KMID: 2288541
• DOI: http://doi.org/10.3802/jgo.2013.24.2.114

Abstract

OBJECTIVE
Extrauterine involvement of endometrial carcinoma has a significant effect on the patients' prognosis and treatment decision. In classical method, macroscopic section is taken from the fallopian tube sparing the fimbrial ends. Fimbrial end of fallopian tube may be involved by tumors and precursor lesions. This study aims to determine the importance of sampling of fimbrial ends of fallopian tube in endometrioid endometrial carcinoma specimens.
METHODS
We reevaluated the fallopian tubes of 200 cases of endometrioid endometrial carcinoma cases that have no macroscopic tubal lesion. A hundred cases were sampled with classical method, and the other 100 were sampled with a new method that includes the fimbrial ends. Statistical difference was examined by Fisher's exact test.
RESULTS
No microscopic tubal lesion lesion was detected in cases that were sampled with the classical method. In contrast, there were 4 cases with tubal lesions in patients sampled with the new technique; 3 of them were located in the fimbrial end. Of the 3, there was one microscopic invasive carcinoma and two proliferative endometrial glandular lesions. Endometriosis was detected in two of the 4 cases with tubal lesions.
CONCLUSION
Including the fimbrial end of fallopian tube to macroscopic sampling could detect more tubal lesions, which might provide additional prognostic and pathogenetic information of endometrioid endometrial carcinoma.

Keyword

Endometrial neoplasms; Endometrioid carcinoma; Endometriosis; Fallopian tube

MeSH Terms

Carcinoma, Endometrioid
Endometrial Neoplasms
Endometriosis
Fallopian Tubes
Female
Humans
Prognosis

Figure

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  Fig. 1 We cut the fallopian tube into two pieces including the fimbrial end (A, B). If the tube measures less than 2 cm, we sample it totally. If it's more than 2 cm, we take a 2 cm sample including the fimbrial end and sample in one cassette (C, D).

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  Fig. 2 Presence of endometriosis foci in fallopian tube (A, B). Note the epithelial continuum between tubal epithelium and the endometrioid lesion (C). Closer view of continuum between the lesion and tubal epithelium (D).

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  Fig. 3 Focus of infiltrative endometrioid carcinoma; a hanging polypoid lesion in the fimbrial end (A). Closer view of the endometrioid tumor (B). Note the continuity between the carcinoma cells and tubal epithelium (C).

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  Fig. 4 These proliferative glandular lesions were observed in different areas from the fallopian tubes of the same patient (A-C) and continuum between normal tubal epithelium and the proliferative lesion can easily be seen in both lesions (C, D).

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