A rare presentation of a pyosalpinx in a post-menopausal wom
Primary fallopian tube carcinoma is a rare tumour of the female genital tract which is generally an intra-operative or a histological diagnosis. It is a tumour that resembles epithelial ovarian cancer. One such case has been reported in the International Journal of Reproduction, Contraception, Obstetrics and Gynecology.

A 61-year-old postmenopausal woman presented with complaints of continuous bleeding per vaginum with history of loss of appetite and weight for 6 months. She was also a known diabetic and hypertensive. On examination, per abdominal, per speculum and per vaginal findings were unremarkable. A transvaginal ultrasonography done previously showed fluid in the endometrial cavity suggestive of hematometra/pyometra due to cervical stenosis.

A fractional curettage done previously had shown strips of acanthotic squamous epithelium in the endocervical curetting. She underwent abdominal hysterectomy with bilateral salpingo ovariectomy. Histopathological findings were suggestive of primary fallopian tube adenocarcinoma. Hence the patient was advised chemotherapy followed by a second look laparotomy.

Lessons learnt:-
- Preoperative diagnosis of fallopian tube carcinoma is difficult due to the silent course of this neoplasm and is usually first appreciated at the time of operation or by a pathologist.

- The treatment approach is similar to that of ovarian carcinoma, and it should consist of a total abdominal hysterectomy with bilateral salpingo-ovariectomy, omentectomy and lymph node dissection from the pelvic and the para-aortic regions.

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