Primary carcinoma of the fallopian tube

Primary carcinoma of the fallopian tube is a rare condition and not easy to diagnose. On a smear taken from the vagina of a 73-year-old woman, cells consistent with adenocarcinoma were detected even though the patient was asymptomatic. The specimen from endometrial curettage was normal on microscopic examination. The patient was readmitted, 2 months after dilatation and curettage, with a right pleural effusion. Examination of the pleural fluid revealed adenocarcinomatous cells. Laparotomy disclosed a primary carcinoma (stage IV) of the left fallopian tube. Thiotepa (45 mg) was instilled into the chest cavity and medroxyprogesterone (100 mg tid) and melphalan (6 mg/d for 4 days over 6 weeks) were given. Although the life expectancy for stage IV primary carcinoma of the fallopian tube is less than 2 years this patient has no clinical evidence of disease 2 1/2 years after operation.