原发性输卵管癌的MR表现.ppt

Primary fallopian tube carcinoma（PFTC）原发性输卵管癌 Epidemiology PFTC is one of the rarest malignancies of the female genital tract, accounting for 0.14-1.8% of all gynaecological malignancies（妇科恶性肿瘤）. occurring predominantly in post-menopausal women at a mean age of 55 years, with women of higher social classes and education being at greater risk. Clinical presentation aetiology（病因学） hormonal（激素）, reproductive（生殖的）, genetic factors may play a role, along with the presence of chronic inflammation of the pelvis. Clinical presentation Characteristic symptoms (Laztkos triad, seen in only 15% of patients) colicky(疝气样) abdominal or pelvic pain adnexal(附件的) mass relieved by intermittent, profuse(大量的), serosanguineous vaginal discharge(阴道排液) Clinical presentation Hydrops tube profluens(输卵管积水)：seen in only 5% of patients The age of presentation is commonly between 40 and 60 years, with a mean age of 55 years. Clinical presentation The pre-operative diagnosis of PFTC is rarely performed, with clinical signs and symptoms pointing towards the more frequently occurring ovarian cancer or pelvic inflammatory disease. Elevated CA-125 levels are indicative of poor prognosis, and can be used during follow-up, as a marker of disease recurrence Pathological diagnosis Serous carcinoma(浆液性癌) of the fallopian tube is the most common histological type The second most common type of tumour is the endometrioid carcinoma(子宫内膜样癌), followed by undifferentiated, clear cell, mucinous, and transitional carinomas. Pathological diagnosis diagnosis criteria of PFTC the main tumour arises from the endosalpinx(输卵管内膜) the histological pattern reproduces the epithelium of the tubal mucosa the transition from benign to malignant tubal epithelium is demonstrable the ovaries or endometrium are either normal or contain a tumour that is smaller than the tumour in the tube Pathological diagnosis Dissemination(播散) of PFTC implantation of cells throughout the abdominal cavity through continuity adjacent organs tr