Abstract
Ovarian cancer (OC) was the third most common gynecological cancer in 2020. Epithelial malignancies account for 95% of OC cases. Indeed, epithelial ovarian cancer (EOC) is the major histologic subtype of OC. Among the EOC subtypes, serous carcinoma is the most prevalent. A diagnosis of OC is usually made in the later stages of the disease, rendering it the most lethal gynecological cancer. We report a rare case of EOC in a middle-aged woman who presented with persistent flank pain and was referred for transabdominal ultrasonography to exclude renal pathology; however, complex bilateral ovarian masses were detected. The imaging features and histopathology led to a diagnosis of bilateral ovarian serous cystadenocarcinoma with peritoneal dissemination and an incidentally discovered cervical fibroid. Hence, this report documents a rare case that underscores the diagnostic challenges posed by incidental findings and highlights the need for both greater awareness and timely intervention in similar clinical scenarios.