The elusive tube: A case report of primary fallopian tube carcinoma

Abstract

Background: Primary fallopian tube carcinoma (PFTC) is a rare gynecologic malignancy often misdiagnosed due to nonspecific symptoms and normal tumor markers. Case Presentation: A 58-year-old parous woman, postmenopausal for 20 years, presented with intermittent watery vaginal discharge and spotting for two months, without abdominal pain. Imaging revealed a bulky left ovary and a separate tubular adnexal lesion. Serum CA-125 was normal. Exploratory laparotomy found a serpiginous cystic lesion with solid component in the left adnexa. Frozen section suggested malignancy. Final histopathology confirmed high-grade serous carcinoma of the left fallopian tube, confined to the tube (FIGO stage IA). Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Postoperative recovery was uneventful. Conclusion: Early-stage PFTC can present with subtle symptoms and normal CA-125. High suspicion and thorough imaging and histopathological evaluation are critical for timely diagnosis and management.