Primary Fallopian Tube Carcinoma Presenting with Isolated Controlateral Inguinal Lymphadenopathy

Primary fallopian tube carcinoma is a rare tumor accounting for <1% of all female genital tract cancers. Presentation primarily as inguinal lymphadenopathy alone is rare. We report a case of a 57-year postmenopausal woman who presented with seven months history of swelling in the right groin, excised and confirmed to be metastatic adenocarcinoma. CA-125 was elevated with a value of 960 U/ml. An exploratory laparoscopy was done, with total abdominal hysterectomy, omentectomy, and appendicectomy, without lymph node dissection. Uterus, right fallopian tube, and ovaries were normal. The left fallopian tube was distended with a mass of 6x5 cm. Histology of left fallopian tube revealed high-grade adenocarcinoma with malignant peritoneal cytology. Histology of right fallopian tube and other structures was normal. The patient received four cycles of adjuvant carboplatin plus taxol with good biological and radiological response. She was referred to our institute for a second look surgery and lymph node dissection. Two months after the end of chemotherapy, she underwent the second surgery consisting of a pelvic, para-aortic and right inguinal lymphadenectomy with a sample from the left inguinal node. There were two metastatic nodes. The patient received six other cycles of carboplatin plus taxol. At present, she remains well, and CA-125 is normal. Fallopian tube adenocarcinoma rarely presents as metastatic inguinal lymphadenectomy. The management of this malignancy is generally the same as epithelial ovarian cancer.