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I have two differential diagnoses: First, it is not uncommon to see prolapsed fimbrea of the left fallopian tube adhesed to the vaginal cuff after a simple hysterectomy. For that possiblity, you need to carefully search if there are some smooth muscle bundles around or adjacent to the glandular structures, as smooth muscle layer is the normal structure of the fallopian tube. However, if it is just the fimbrea end. smooth muscle bundle is not necessary to make diagnosis. In this case, all the glands are ciliated glandular cells and should rule out this possiblity. Secondly, it is possible an endometriosis with tubal metaplasia. In either case, it should be a benign process, not overdiagnosed as malignancy, such as endometrial adenocarcinoa. This patient is relatively young for the endometrial malignancy.