Incidental tubal pathology from pelvic organ prolapse surgery

Incidental gynaecologic malignancies are detected in up to 1.3% of pelvic organ prolapse (POP) surgeries. There is limited data on the incidence of fallopian tube pre-malignancies, such as serous tubal intraepithelial lesion (STIL) and carcinoma (STIC), which progress to ovarian cancer in 10.5% of patients over 5 years. We report two new cases of incidental tubal pathology after POP surgery. Patient one is a woman in her 70s who underwent a laparoscopically assisted vaginal hysterectomy and bilateral salpingectomy with sacrocolpopexy, revealing STIC and STIL in the left adnexa. Follow-up laparoscopic bilateral oophorectomy with peritoneal biopsies was benign. Patient two is a woman in her 70s who underwent vaginal hysterectomy, left salpingectomy, uterosacral ligament suspension and enterocele repair and was found to have STIL. Follow-up robotic bilateral oophorectomy, right salpingectomy and peritoneal biopsies were benign. Patients with incidental tubal carcinoma should be monitored by gynaecologic oncology to prevent progression to ovarian cancer.