Fallopian tube carcinoma: incidental finding during surgery for acute pelvic inflammatory disease--case report

BACKGROUND: Primary carcinoma of the fallopian tube is a rare condition. Preoperative diagnosis is difficult and in most cases it is an intraoperative finding or a histopathological diagnosis. CASE: A 49-year-old woman presented with pelvic pain, fever (38 degrees C), elevated white blood cell count and a right adnexal mass. Pelvic inflammatory disease was suspected and broad spectrum antibiotics were established. Five days later, due to lack of clinical response, a total abdominal hysterectomy, bilateral salpingo-oophorectomy and appendectomy were performed. Histopathology showed a primary fallopian tube carcinoma. Postoperatively she received chemotherapy. Afterwards she underwent a staging laparotomy. Some months later, new chemotherapy regimens were instituted because of the presence of lymph node metastases. CONCLUSION: Malignancy should be included in the differential diagnosis of pelvic inflammatory disease.