Primary carcinoma of the fallopian tube (FTC) is extremely rare. We report a case of serous adenocarcinoma of the fallopian tube. A 60-year-old, nulliparous and post-menopausal woman had a complaint of serohaemorrhagical vaginal discharge. Laboratory results, including serum CA-125, were normal. Transvaginal ultrasonography (US) revealed a tubular cystic lesion with multiple echogenic mural nodules in the right adnexal region. On computed tomography (CT), a well-delineated, tubular, hypodense lesion with thickened wall, mural nodular densities and septations was detected. Fallopian tube tumour was suspected radiologically and was proved operatively and histopathologically. The clinical and radiological clues that were of help in the diagnosis were discussed. © 2003 Elsevier Ireland Ltd. All rights reserved.