Congenital Ampullary Atresia of the Fallopian Tube and the Coexistence of Fimbrial Tissue

Objectives: To contribute 3 additional cases of congenital ampullary atresia to the 5 in our previously published case series. To document the constant coexistence of ipsilateral fimbrial tissue, to review the literature and to reconcile this finding with novel concepts of ovarian carcinogenesis. Design: Case series. Setting: Tertiary academic referral centre. Patients: Cases of congenital ampullary atresia referred with infertility due to unilateral or bilateral ampullary obstruction over the years 2003-2012. Intervention: Observation. Main outcome measure: The presence of fimbrial tissue that coexists ipsilateral to a fallopian tube with congenital ampullary atresia. Result: In all 3 cases fimbrial tissue was present ipsilateral to the congenital ampullary atresia. Conclusion: There is a reliable finding of fimbrial tissue ipsilateral to congenital ampullary atresia in our series and, as can be reasonably ascertained, in all cases of CAA in the literature. This observation is consistent with a commonality of congenital celomic origin between fimbria and ovary, and with recent observations that there is molecular continuity between fimbria and the ovarian surface epithelium; and that niche cancer-prone stem cells populate the junction between fimbria and ovary.