Expression of insulin-like growth factor-1 receptors, Wilm's tumor-1 protein, c-kit and p16 in primary fallopian tube carcinoma in diabetic patients

Background: Primary fallopian tube carcinoma (PFTC) represents less than 1% of all gynecological malignancies and its association with diabetes mellitus is seldom reported. Cases: We report three cases of PFTC presented primarily as advanced ovarian cancer while the primary site totally silent. Two of them were diabetics and showed expression of insulin-like growth factor receptors, Wilm's tumor protein-1, c-kit and P16. In all these cases there was neither clinical nor perioperative suspicion of PFTC and the first clinical diagnosis was ovarian carcinoma which was supported by positive cytology for ascitic fluid and raised serum level of CA125. The diagnosis was only established after histopathologic examination of serial sections of the whole fallopian tube since we were able to demonstrate the continuity between the invasive and the in situ components of PFTC in the lining epithelial layer of the fallopian tube. Conclusion: The presence of malignant cells in the female pelvic organs without a mass should raise the possibility of primary fallopian tube carcinoma. Pre-operative diagnosis of PFTC is seldom made and most of the time the diagnosis is made after histopathological examination as in our cases. Diabetes mellitus can be a risk factor in the development of PFTC.