Introduction/Background Schistosomiasis in female reproductive tract is very uncommon. A systematic review estimated that more than 200 million people are infected across the tropical areas, and 800 million at risk of infection. We present case of a patient who underwent surgery for suspected ovarian cancer and was incidentally diagnosed with ectopic schistosomiasis.

Methodology A 59-year-old lady who was investigated for suspected kidney disease was incidentally diagnosed with on ultrasound to have complex right sided 8 cm ovarian mass. She further had a CT scan which confirmed the same findings. In her personal history she was noted to have type 2 diabetes and hypertension. As per multidisciplinary team advice she proceeded for total abdominal hysterectomy, bilateral oophorectomy and omental biopsy. She had a CA 125 level of 25 IU/ml and Risk malignancy index was 150.

Results She underwent midline laparotomy and findings included an 8 × 10 cm complex right ovarian cyst with mild omental thickening. Another biopsy was taken from a right sided infundibulopelvic ligament 1 cm white nodule. Histology showed a benign mature cystic teratoma of right ovary and benign endometrial polyp. It also incidentally showed ectopic schistosomiasis in the right infundibulopelvic ligament biopsy. On enquiry she had history of travel to Egypt twice in last 5 years. She underwent HIV and total immunoglobulins serology under infectious disease team. She was treated with two doses Praziquantel.

Conclusion Schistosomiasis is prevalent in Africa, tropical areas and Asia. It can be acute or chronic and has association with HIV, HPV and STI’s. Chronic disease with up to 10 years life span in human body results from the host’s immune response to deposited eggs and the granulomatous reaction caused by antigens. It is important to biopsy any suspicious areas during surgery to thoroughly assess for any pathology like in our case to improve diagnosis.

Disclosure Nothing to disclose.