Fallopian Tube Cancer Overview

Fallopian tube cancer forms in the two hollow, muscular ducts that connect the ovaries to the uterus in the female reproductive system. After ovulation, eggs produced by the ovaries will pass into the fallopian tubes, where fertilization can occur. After conception, the fertilized egg will pass into the uterus, where the fetus will develop.

Primary fallopian tube cancer is relatively rare, accounting for approximately 2% of all female reproductive cancers. More often, the tumor originates in another part of the body, such as the ovaries or endometrium, and then spreads to the fallopian tubes.

Fallopian Tube Cancer Types

Also known as tubal cancer, fallopian tube cancer is classified based on its cellular origin:

• Adenocarcinoma – Develops in the glandular cells that line the fallopian tubes (most common)
• Sarcoma – Forms in the smooth muscular tissues of the fallopian tubes
• Transitional cell carcinoma – Arises in cells in the fallopian tubes that resemble the transitional cells in the lining of the urinary tract (extremely rare)

Fallopian Tube Cancer Causes and Factors

Tubal cancer develops when cells in the fallopian tubes undergo harmful genetic mutations that cause them to grow uncontrollably. The excess cells then build up, bind together and form tumors.

The exact cause of the cellular changes that lead to the development of fallopian tube cancer is often unknown. However, scientists have identified several risk factors, including:

• Inherited gene mutations – A mutation in breast cancer gene 1 (BRCA1) or breast cancer gene 2 (BRCA2), which can be inherited from either parent
• Personal history – A previous diagnosis of breast, ovarian or primary peritoneal cancer
• Family history – A first-degree biological relative (mother, sister or daughter) who was diagnosed with breast, ovarian or fallopian tube cancer
• Hormone replacement therapy (HRT) – Prolonged use of HRT to manage menopause symptoms, such as hot flashes and vaginal dryness
• Certain medical conditions – Pelvic inflammatory disease, salpingitis and other conditions that cause chronic inflammation of the fallopian tubes
• Pregnancy and childbirth history – Never being pregnant or never giving birth
• Lifestyle factors – Smoking and obesity

Fallopian Tube Cancer Signs and Symptoms

The first sign of tubal cancer is often abnormal or irregular vaginal bleeding, especially in postmenopausal women. This symptom can occur even in the early stages of tumor development and is a significant indicator that warrants prompt medical evaluation.

What Does Fallopian Tube Cancer Feel Like?

Tubal cancer may cause pelvic or abdominal pain, which can be persistent or intermittent, along with a sense of fullness or pressure in the lower abdomen. The discomfort can vary in intensity and may be accompanied by general fatigue or malaise. As the tumor progresses, it may also cause frequent urination and changes in bowel habits, such as chronic diarrhea or constipation.

During a pelvic examination, a physician may feel an abnormal mass or detect signs of fluid accumulation in the pelvis.

What Does Fallopian Tube Cancer Look Like?

In addition to abnormal vaginal bleeding, some women report unusual vaginal discharge, which may be watery or blood-tinged. As the tumor grows, it may cause abdominal bloating and noticeable weight loss.

In medical imaging studies, such as ultrasound, computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) scans, the tumor may look like a mass or thickening in the fallopian tube.

Fallopian Tube Cancer Diagnosis

If tubal cancer is suspected based on the symptoms, a physician will typically perform a comprehensive physical examination and order diagnostic testing, such as:

• Blood work – A cancer antigen 125 (CA-125) blood test measures the amount of CA-125 in the blood, which may be elevated if fallopian tube cancer is present.
• Imaging tests – A transvaginal ultrasound, CT, MRI or PET scan can help the physician identify cysts and tumors in the fallopian tubes.

To rule out or confirm a diagnosis of fallopian tube cancer, the physician will order a biopsy to obtain a tissue sample for microscopic examination by a pathologist. This procedure can be performed with ultrasound or CT scan guidance.

Fallopian Tube Cancer Stages

Tubal cancer is staged using the International Federation of Gynecology and Obstetrics (FIGO) staging system or the American Joint Committee on Cancer (AJCC) TNM staging system. Both systems assign a stage ranging from 1 to 4 based on the extent of tumor spread. A higher number indicates more invasive cancer.

Stage 1 Fallopian Tube Cancer

At stage 1, the tumor is localized within one or both fallopian tubes and has not spread to other pelvic organs, lymph nodes or distant sites. Stage 1 fallopian tube cancer can be further classified as:

• Stage 1A – The tumor is confined to the inside of one fallopian tube and has not invaded its outer surface.
• Stage 1B – Cancer is present in both fallopian tubes.
• Stage 1C – The tumor has spread to the outer surface of the fallopian tube, the fallopian tube has ruptured or cancerous cells are present in the abdominal fluid.

The prognosis for early-stage fallopian tube cancer is generally favorable. The primary treatment is surgical removal of the cancerous tissues.

Stage 2 Fallopian Tube Cancer

At stage 2, the tumor has spread beyond the fallopian tubes to nearby pelvic structures but remains confined to the pelvic region; it has not reached nearby lymph nodes or distant organs. Stage 2 fallopian tube cancer can be further classified as:

• Stage 2A – The tumor has spread to the uterus and/or ovaries.
• Stage 2B – The tumor has spread to other pelvic structures, such as the bladder or rectum.

Treatment typically involves surgical removal of the cancerous tissues, often followed by chemotherapy to address any remaining cancer cells and reduce the risk of recurrence.

Stage 3 Fallopian Tube Cancer

At stage 3, the tumor has spread beyond the pelvic region to the abdominal cavity or nearby lymph nodes. Stage 3 fallopian tube cancer can be further classified as:

• Stage 3A – Microscopic cancer cells are found in the peritoneum outside the pelvis.
• Stage 3B – Visible cancerous deposits smaller than 2 cm. in diameter are present in the abdomen.
• Stage 3C – Visible cancerous deposits larger than 2 cm. in diameter are present in the abdomen or cancer has spread to nearby lymph nodes.

Treatment typically involves surgery to remove as much of the cancer as possible, followed by chemotherapy to target any remaining cancer cells.

Stage 4 Fallopian Tube Cancer

At stage 4, the cancer has metastasized beyond the abdominal cavity to distant tissues or organs, such as the liver or lungs. Metastatic fallopian tube cancer can be further classified as:

• Stage 4A – Cancerous cells are present in the fluid around the lungs (pleural effusion).
• Stage 4B – The tumor has spread to organs and tissues outside the abdomen.

Treatment for advanced-stage fallopian tube cancer may involve surgery to remove as much of the tumor as possible along with systemic therapy, such as chemotherapy, targeted therapy or immunotherapy, to manage the progression of the cancer and alleviate its symptoms.

Fallopian Tube Cancer Treatment

Treatment options for tubal cancer may include:

• Surgery – A surgeon may perform exploratory surgery to diagnose fallopian tube cancer, a hysterectomy to remove the uterus (hysterectomy), a salpingectomy to remove the fallopian tubes and or an oophorectomy to remove the ovaries. Depending on the patient’s diagnosis, age and preferences, a fertility-preserving procedure may be considered to remove only the tumor.
• Chemotherapy – Chemo may be administered before surgery to shrink the tumor and make it easier to remove or after surgery to destroy any remaining cancer cells and help prevent a recurrence. Sometimes, heated chemotherapy is delivered during surgery to allow for a more concentrated dose (hyperthermic intraoperative peritoneal chemotherapy).
• Targeted therapy – Drugs or other substances are administered to target and damage the specific molecules in the cancer cells that fuel tumor growth. Targeted therapy may be considered for a patient who has a BRCA genetic mutation.
• Immunotherapy – Drugs or other substances are administered to boost the body’s immune system and help it recognize, attack and destroy the cancer cells.

Benefit from World-Class Care at TGH

Tampa General Hospital is a world-class, high-volume medical center recognized by U.S. News & World Report as One of the Nation's Best Hospitals for Cancer Care for 2024-25. The multidisciplinary team in our Cancer Institute has extensive experience in diagnosing and treating all types and stages of gynecologic cancer, including tubal cancer and other uncommon conditions.

If you would like to learn more about fallopian tube cancer, contact TGH at (813) 844-7585 to request an appointment with a gynecologic oncologist at our Cancer Institute in Tampa, FL.