[Preoperative diagnosis of fallopian tube carcinoma by cytology]

Carcinoma of the fallopian tube is a rare, extremely aggressive neoplasm that is uncommonly diagnosed in early stages of the disease. We present a case of a 56-year-old nulliparous patient with tubal carcinoma stage Ic (FIGO). Preoperatively, the only suspect finding were atypical glandular cells of extrauterine origin presented on a routine Papanicolaou smear. Histopathologic finding of D&C implicated the same suspicion of extrauterine genital malignancy. After hysterectomy with bilateral adnexectomy and omentectomy, histopathology confirmed stage I primary adenocarcinoma of the right fallopian tube (alveomedullary type) with positive intraoperative cytology of Douglas pouch lavage. As the patient had bilateral occlusion of the tubes, we presumed that tumor cells were leaking through the uterus into the vagina, and we were luckily alerted within the pathological cervical smear to the possible presence of a malignancy in the abdomen. The patient received 6 courses of cyclophosphamide and cisplatin chemotherapy postoperatively. Two years after the diagnosis, the patient is healthy, without a trace of primary malignant disease. Cytology undoubtedly plays a vital role as a screening tool in the detection of premalignant and malignant diseases of the female genital tract, particularly lesions in the uterine cervix. However, its role in clinical staging of gynecologic diseases should not be underestimated either, due to its ability to detect malignant epithelial cells in peritoneal samples as well as for its detecting and diagnostic value in other malignant gynecologic diseases.