Preoperative diagnosis of fallopian tube carcinoma is difficult, with fewer than 5% being diagnosed preoperatively. We describe tubal carcinoma, presenting as a tubo-ovarian abscess in two 47-year-old women. Both patients presented with abdominal pain, pelvic mass, and fever. Both patients were treated as having a tubo-ovarian abscess but failed to respond to therapy. During surgery a metastatic right tubal carcinoma was found. A definite operation was performed in both patients. Three additional cases of fallopian tube carcinoma, presenting as acute pelvic inflammatory disease, were found while reviewing the English literature. Actually all these three cases presented as tubo-ovarian abscess because of the existence of tender pelvic mass. Carcinoma of the fallopian tube should be considered in the differential diagnosis of tubo-ovarian abscess in those who failed to respond to a previously unreported clinical presentation.
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