Computed tomography appearance of primary fallopian tube carcinoma with pathologic correlation

Our purpose is to describe the computed tomography appearance of the adnexal mass and regional tumor spread in primary fallopian tube carcinoma with pathologic correlation. Computed tomography scans of seven patients with fallopian tube carcinoma were evaluated for adnexal mass laterality, attenuation (solid or cystic), and shape (ovoid, straight-tubular, or convoluted-tubular). An attempt to identify the ovaries separately from the adnexal mass was made by following the ovarian venous course. An enlarged ovary or one inseparable from the adnexal mass was considered involved. Endometrial thickening or direct uterine-adnexal mass continuity was considered uterine involvement. CT results were compared with surgical pathology. Eight adnexal masses were unilateral in six patients and bilateral in one. Seven (88%) of these lesions were predominantly cystic. Three (37%) lesions were ovoid, two (26%) were straight-tubular, and three (37%) were convoluted-tubular. Separate ovaries were identified in association with two (25%) of the eight adnexal masses. Of thirteen removed ovaries, seven (53%) contained metastasis of which CT suggested tumor involvement in five (71%). On CT, five of eleven ovaries appeared normal of which only three (60%) did not contain metastasis. Two of five removed uteri contained metastases; only one appeared involved on CT. CT correlated with pathologic specimens in eight (61%) of thirteen ovaries and four (80%) of five uteri. Although PFTC is a rare disease, this diagnosis can be suggested on CT in select cases where an ipsilateral ovary is normal in appearance and distinct from an adnexal mass that has a convoluted-tubular or straight-tubular cystic component. Identifying the ovaries separately from the adnexal mass on CT is helpful to exclude primary ovarian neoplasm, but CT is not sensitive for detecting ovarian invasion.