Aim: We describe the unusual association of fallopian tubal prolapse and he
rpetic infection, an occurrence not previously reported to our knowledge.
Methods and results: A 37-year-old woman presented with a small polypoid ma
ss of the vaginal vault, 3 months after abdominal hysterectomy and abdomino
plasty. The vaginal mass proved to be the fimbriated end of a fallopian tub
e, herniated into the vagina. Reintervention 3 months later with resection
of a small vaginal 'polyp' revealed a residual portion of fallopian tube, w
ith superimposed herpes simplex virus (HSV) infection and marked cytologica
l atypia of surface epithelial cells. HSV-2 immunostaining of viral nuclear
inclusions and of atypical cells confirmed the herpetic nature of the infe
ction.
Conclusion: Involvement of the genito-urinary tract by HSV may occur via an
ascending infection from the cervix, but the fallopian tube, deeply locate
d in the pelvis, is generally spared from herpetic infection. In the settin
g of fallopian tubal prolapse, direct exposure of the herniated fallopian t
ube to various pathogens in the vagina provides an unique clinical model fo
r salpingitis. In herpetic tubal infections, special attention must be paid
to cytological atypia of probable viral cytopathogenic origin, to avoid a
misdiagnosis of malignancy.