Primary fallopian tube carcinoma: Preoperative diagnostic dilemma

Primary fallopian tube carcinoma is an uncommon female genital tract malignancy that resembles epithelial ovarian neoplasm clinically and radiologically. We present a case of 49-year-old woman with postmenopausal intermittent vaginal bleeding, lower abdominal pain, and pelvic mass for 3 months. On physical examination, lower abdominal tenderness was found. Ultrasound examination revealed bilateral hydrosalpinx with hematometra. Her serum cancer antigen-125 was raised (190.0 U/ml). With the clinical diagnosis of endometrial cancer, patient underwent total abdominal hysterectomy with bilateral salpingo-oopherectomy, infracolic omentectomy and rectal deposit biopsy. Microscopic examination showed features of serous adenocarcinoma of the fallopian tube. Histologically, it is indistinguishable from primary ovarian malignancy. On post-surgical follow up at one year the patient is disease free. Here we report this rare entity and review the literature to highlight the preoperative clinical diagnostic difficulties.