Robotic-assisted laparoscopic cytoreductive surgery for lobular carcinoma of the breast metastatic to the ovaries

The first case of robotic-assisted laparoscopic cytoreductive surgery for a metastatic malignant ovarian tumor is described. A 65-year-old woman who was treated for breast cancer 13 years earlier presented with a deep venous thrombosis in the right leg and a pelvic mass. Imaging tests showed bilateral solid ovarian tumors and an enlarged lymph node at the level of the right common iliac vessels but no evidence of any other tumor metastases. The patient was offered and accepted to undergo a da Vinci robotic-assisted bilateral adnexectomy with hysterectomy and pelvic lymph node sampling. The surgery took 200 minutes, and the patient was discharged uneventfully on the third postoperative day. Histologic examination showed strongly estrogen receptor–positive metastatic lobular carcinoma of the breast in both ovaries and fallopian tubes. She was further treated with adjuvant exemestane and is currently doing well. It is possible to treat selected patients with malignant ovarian tumors by robotic-assisted laparoscopy.