The patient, a 70-year-old woman, sought medical attention after experiencing abnormal uterine bleeding for 9 days. She reported no urinary frequency, urgency, abdominal pain, bloody stools, or weight loss. A local hospital conducted an outpatient ultrasound, revealing a cystic space in the right adnexal region with no apparent abnormalities on the left side. A small amount of fluid was also observed in the uterine cavity. The patient was subsequently referred to Gansu Provincial People’s Hospital for further evaluation and was admitted with a pelvic mass.
Upon admission, gynecological examination revealed cervical hypertrophy with erosion-like changes, accompanied by weak positive contact bleeding. The patient’s premenopausal ovarian cancer risk assessment was 21.48%. Additionally, she had a medical history of nevoid basal cell carcinoma syndrome (Gorlin syndrome), congenital atrial septal bulging tumor, and type 2 diabetes mellitus. To investigate the patient’s condition, exploratory laparoscopy was performed. Preoperative gynecologic ultrasound confirmed the presence of tubal effusion, as evidenced in Figs. 1 and 2.
During the procedure, the right fallopian tube exhibited conspicuous thickening in a saliciform pattern, displaying a purplish-blue hue. A cystic mass measuring 10*5 cm was identified, devoid of any apparent metastases in the uterus, greater omentum, ovary, peritoneum, or diaphragm. Intraoperative frozen pathological examination of the resected specimen suggested a high likelihood of malignant plasma tumor in the right adnexa. Consequently, the surgical approach was expanded to include laparoscopic exploration, right adnexectomy, hysterectomy, left adnexectomy, salpingo-oophorectomy, and laparotomy. Subsequent pathological biopsy, coupled with immunohistochemistry, confirmed the following findings: 1. Interstitial smooth muscle tumor of the uterine myometrium; 2. Chronic inflammation of the cervix; 3. High-grade plasmacytoid fallopian tube carcinoma in the right fallopian tube, Stage IA (FIGO staging) (illustrated in Fig. 3) was identified. Following the postoperative period, a decision was made to administer six cycles of chemotherapy comprising paclitaxel in combination with carboplatin. At the time of composing this article, the patient has been under telephone surveillance and has completed the prescribed chemotherapy in a local medical facility, in accordance with her wishes. Encouragingly, the patient has not exhibited any signs of metastasis post-chemotherapy and is currently experiencing a satisfactory recovery.