We report the first documented case of primary fallopian tube carcinoma with isolated appendiceal metastasis. A 67-year-old postmenopausal woman was referred for an asymptomatic adnexal mass that was discovered incidentally by transvaginal ultrasound during a routine cancer screening. Abdominal-pelvic CT and pelvic MRI showed a 6 cm right tubal mass suggesting malignancy. A second suspicious 2 cm solid appendiceal mass was found to be metastatic. Debulking surgery diagnosed a right tubal high-grade serous carcinoma. No gross or microscopic metastasis was found in the abdominal cavity, apart from an appendiceal metastasis without sites of serosal involvement.