Incidental small ovarian surface serous carcinoma with miliary abdominal seeding during robotically-assisted total hysterectomy

Objective: To report a case in which an incidental finding of an extremely small ovarian surface tumor with abdominal miliary seeding was managed using robotic staging surgery. Case Report: A 53-year-old women, gravida 0 para 0, who was experiencing dysmenorrhea and adenomyosis, was admitted initially for robotically-assisted total hysterectomy. Intraoperatively, an incidental discovery of a 0.5-cm right ovarian surface tumor with pelvic wall miliary tumors was noted. An intraoperative frozen-section diagnosis revealed carcinoma both for the ovarian tumor and pelvic sidewall tumors. A final pathological report revealed serous carcinoma, Stage IIIA2. Conclusion: A preoperatively undetectable small ovarian tumor (0.5 cm) could behave malignantly with metastasis that is already widespread. The authors have reported this case to identify the imperative need for early detection of ovarian cancer.