BACKGROUND Tuberculosis is quite prevalent in developing countries, including India. In the female genital tract, the fallopian tube is the most common site involved by the disease. METHODS A woman presented with infertility, menstrual irregularities, an abdominal mass, abdominal pain and weight loss. She was previously operated on for left ovarian germ cell tumor. The clinical, radiologic and histopathologic examination helped to reach the correct diagnosis. CONCLUSIONS In a woman with a history of infertility, menstrual irregularities, an abdominal mass and weight loss, differentiation between malignancy and tuberculosis becomes difficult. These two possibilities should always be part of the differential diagnosis.