• Chin-Tzu Tien, Chiu-Hsuan Cheng, and Dah-Ching Ding.
• Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien, Taiwan.
• Medicine (Baltimore). 2022 Nov 4; 101 (44): e31205e31205.

RationaleOvarian cystadenofibroma is a relatively rare benign ovarian tumor. Ovarian remnant syndrome (ORS) is a rare complication of bilateral salpingo-oophorectomy (BSO). We report a rare case of ORS with paraintestinal ovarian serous cystadenofibroma that developed 30 years after total abdominal hysterectomy and BSO in a 73-year-old woman.Patient ConcernsA 73-year-old woman complained of long-term lower abdominal discomfort.DiagnosisShe was diagnosed with a cystic lesion in the lower abdomen on transabdominal ultrasonography. Further diagnostic imaging and laboratory tests could not exclude a diagnosis of malignancy.InterventionsThe patient underwent laparoendoscopic single-site surgery. We found one cystic lesion 5 cm in size with multiple septa that was adhered to the small bowel. We consulted a general surgeon for tumor resection. Dissection was performed and the specimen was then removed from the umbilical wound.OutcomesHistopathological examination revealed an ovarian serous cystadenofibroma. The postoperative recovery was uneventful.LessonsPatients with lower abdominal pain after a previous hysterectomy and BSO should be examined with transabdominal sonography for ORS.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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