Clinical and ultrasound characteristics of primary fallopian tube carcinoma: a single-institution retrospective study of 280 cases

Objective: This study aimed to describe the sonographic and clinical characteristics of primary tubal carcinoma, a rare gynecological malignancy. Methods: This was a retrospective, single center study that include 280 patients with postoperative histological diagnosed fallopian tube carcinoma. All patients underwent preoperative ultrasound and surgery at Obstetrics and Gynecology Hospital of Fudan University in 2020-2024. Clinical data and ultrasound variables were collected. Results: The most common complaint was abdominal pain/bloating (35.71%) whilst 42.14% were asymptomatic. High-grade serous carcinoma was the predominant histological type (95.36%). Unilateral masses were more common (47.14%). Oval masses were the most prevalent ultrasonic appearance (58.15%). Endometrial fluid was observed in 28.57% cases. In 67.15% of cases, ultrasound diagnosis accurately described the dominant mass in accordance with the intraoperative observation. Ovarian-dominant masses had significantly higher CA125 levels and larger diameters than tubal-dominant masses. Conclusion: Abdominal pain/distension and endometrial fluid should raise more attention in the diagnosis of tubal cancer. A characteristic pattern of "large metastases and small primary lesions" was found in the tubal cancer sonography. Oval lesions were observed more frequently than sausage-shaped lesions in fallopian tube cancer, with the masses predominantly being solid or predominantly solid.