PMID- 26646473
OWN - NLM
STAT- MEDLINE
DCOM- 20180713
LR  - 20201218
IS  - 1752-699X (Electronic)
IS  - 1752-6981 (Linking)
VI  - 11
IP  - 6
DP  - 2017 Nov
TI  - Clinically occult primary fallopian tube carcinoma presenting as a malignant 
      pleural effusion.
PG  - 1086-1090
LID - 10.1111/crj.12423 [doi]
AB  - We report the first known case of malignant pleural effusion (MPE) as the sole 
      presenting feature of clinically occult primary fallopian tube carcinoma (PFTC). 
      A 57-year-old healthy woman was admitted with dyspnea. Evaluation demonstrated a 
      right pleural effusion, fluid of which was malignant. The immunohistochemical 
      profile, including negative calretinin, favored metastatic adenocarcinoma over 
      mesothelioma but could not identify the primary tumour site. Pleural biopsy was 
      not pursued as it would not have helped localize the primary. Chest, abdomen and 
      pelvic computed tomography (CT) demonstrated only borderline lymphadenopathy in 
      the left para-aortic lymph node chain that was hypermetabolic on positron 
      emission tomography. Ultrasound and CT showed normal adnexal anatomy. These 
      findings, coupled with an elevated serum CA-125, prompted empiric neoadjuvant 
      chemotherapy targeting epithelial ovarian carcinoma (EOC) followed by surgery, 
      which revealed a tiny left PFTC with negative peritoneal washings. Sampled left 
      para-aortic lymph nodes were positive. The pleural effusion resolved after 
      chemotherapy. Malignant pleural disease without peritoneal involvement is more 
      characteristic of PFTC than of EOC, in which MPE is common but almost always 
      accompanies peritoneal carcinomatosis. The extensive lymphatic supply of the 
      fallopian tube promotes distant metastasis of small, seemingly localized tumours. 
      This case is a reminder that the clinician should not be dissuaded from 
      considering carcinoma of Mullerian origin, especially PFTC, as the cause of a MPE 
      even in the face of normal gynecologic imaging. Appropriately broad 
      immunohistochemical staining and careful attention to even minimal 
      lymphadenopathy can be invaluable in pinpointing the primary tumour site in such 
      patients.
CI  - (c) 2015 John Wiley & Sons Ltd.
FAU - Hiensch, Robert
AU  - Hiensch R
AD  - Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of 
      Medicine at Mount Sinai, New York, NY, 10029, USA.
FAU - Meinhof, Klaus
AU  - Meinhof K
AD  - Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of 
      Medicine at Mount Sinai, New York, NY, 10029, USA.
FAU - Leytin, Anatoly
AU  - Leytin A
AD  - Department of Pathology, Elmhurst Hospital Center, Icahn School of Medicine at 
      Mount Sinai, Queens, NY, 11373, USA.
FAU - Hagopian, George
AU  - Hagopian G
AD  - Division of Gynecologic Oncology, Elmhurst Hospital Center, Icahn School of 
      Medicine at Mount Sinai, Queens, NY, 11373, USA.
FAU - Szemraj, Eva
AU  - Szemraj E
AD  - Division of Hematology and Oncology, Elmhurst Hospital Center, Icahn School of 
      Medicine at Mount Sinai, Queens, NY, 11373, USA.
FAU - Epelbaum, Oleg
AU  - Epelbaum O
AD  - Division of Pulmonary and Critical Care Medicine, Elmhurst Hospital Center, Icahn 
      School of Medicine at Mount Sinai, Queens, NY, 11373, USA.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20160104
PL  - England
TA  - Clin Respir J
JT  - The clinical respiratory journal
JID - 101315570
SB  - IM
MH  - Carcinoma/drug therapy/*pathology/surgery
MH  - Carcinoma, Ovarian Epithelial
MH  - Chemotherapy, Adjuvant/methods
MH  - Dyspnea/diagnosis/etiology
MH  - Fallopian Tube Neoplasms/*pathology
MH  - Fallopian Tubes/*pathology
MH  - Female
MH  - Humans
MH  - Immunohistochemistry/methods
MH  - Lung Neoplasms/metabolism/*pathology/secondary
MH  - Lymphatic Metastasis/pathology
MH  - Mesothelioma/metabolism/*pathology/secondary
MH  - Mesothelioma, Malignant
MH  - Middle Aged
MH  - Neoplasms, Glandular and Epithelial/drug therapy/metabolism/pathology/surgery
MH  - Ovarian Neoplasms/drug therapy/metabolism/pathology/surgery
MH  - Pleura/pathology
MH  - Pleural Effusion, Malignant/drug therapy/etiology/*pathology/surgery
MH  - Positron-Emission Tomography/methods
MH  - Thoracentesis/methods
MH  - Tomography, X-Ray Computed/methods
OTO - NOTNLM
OT  - carcinoma of unknown primary - immunohistochemistry - malignant pleural effusion 
      - primary fallopian tube carcinoma
EDAT- 2015/12/10 06:00
MHDA- 2018/07/14 06:00
CRDT- 2015/12/10 06:00
PHST- 2015/03/10 00:00 [received]
PHST- 2015/09/14 00:00 [revised]
PHST- 2015/11/13 00:00 [accepted]
PHST- 2015/12/10 06:00 [pubmed]
PHST- 2018/07/14 06:00 [medline]
PHST- 2015/12/10 06:00 [entrez]
AID - 10.1111/crj.12423 [doi]
PST - ppublish
SO  - Clin Respir J. 2017 Nov;11(6):1086-1090. doi: 10.1111/crj.12423. Epub 2016 Jan 4.