Ultrasound characteristics of primary fallopian tube carcinoma and the misdiagnosis and missed diagnosis.

Objective: This study retrospectively analyzed the ultrasound characteristics of primary fallopian tube carcinoma (PFTC) and the misdiagnosis and missed diagnosis.

Methods: Data of 15 PFTC patients undergoing surgical treatment in Affiliated Xiaoshan Hospital, Hangzhou Normal University from August 2013 to September 2022 were collected. The clinical features, ultrasound characteristics, pathological diagnosis results and misdiagnosis and missed diagnosis by ultrasound were analyzed.

Results: In 15 patients, there were 8 (53.33%) cases with vaginal bleeding, 6 (40.00%) cases with abdominal pain, five (33.33%) cases with pelvic mass, and two (13.33%) cases with vaginal discharge. There were 11 (73.33%) cases with CA125 level ≥ 35 U/ml. In 15 patients, 10 cases presented a sausage-shaped mass in adnexal region (type I PFTC) (two cases of cystic mass with papillary nodules, three cases of cystic-solid mass, five cases of hypoechoic or heterogeneous hypoechoic solid mass), four cases presented irregular hypoechoic mass in adnexal region (type II PFTC), and one case did not present the mass (type III PFTC). In 15 patients, three cases were accompanied by hydrosalpinx, two cases were accompanied by uterine fluid accumulation, and five cases were accompanied by abdominal or pelvic fluid accumulation. There were totally seven (46.66%) cases misdiagnosed or missed of diagnosis by ultrasound.

Conclusion: The clinical manifestations of PFTC are diverse and lack of specificity. The ultrasound examination may have the misdiagnosis and missed diagnosis. PFTC should be highly suspected when there are characteristic ultrasound images including sausage-shaped mass companied by hydrosalpinx, uterine fluid accumulation, or abdominal or pelvic fluid accumulation. If the mass is small, it is prone to missed diagnosis.