Romanian medical JouRnal | Revista medicală Română– volume 69, suppl. 4, 2022 34 PAPER 10 Ref: Ro Med J. 2022;69(Suppl4) DOI: 10.37897/RMJ.2022.S4.10 Omental cake invading the urinary bladder – a case report and literature review Nicolae Bacalbasa 1,2 , Irina Balescu 3 , Claudia Stoica 4,5 , Cristina Martac 6 , Valentin Varlas 1,7 , Andrei Voichitoiu 1,8 , Lucian Pop 1,8 , Sorin Petrea 9 , Mihaela Vilcu 9,10 , Iulian Brezean 9,10 1 Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania 2 Department of Visceral Surgery, Center of Excellence in Translatonal Medicine, Fundeni Clinical Insttute, Bucharest, Romania 3 Department of Visceral Surgery, Ponderas Academic Hospital, Bucharest, Romania 4 Department of Anatomy, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania 5 Department of Surgery, Ilfov County Emergency Hospital, Bucharest, Romania 6 Department of Anesthesiology, Fundeni Clinical Insttute, Bucharest, Romania 7 Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, Bucharest, Romania 8 Department of Obstetrics and Gynecology, ”Alessandrescu-Rusescu” Natonal Insttute of Mother and Child Care, Bucharest, Romania 9 Department of Surgery, “Dr. I. Cantacuzino” Clinical Hospital, Bucharest, Romania 10 Department of Surgery, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania Corresponding author: Nicolae Bacalbasa E-mail: nicolae_bacalbasa@yahoo.ro Article History: Received: 18 April 2022 Accepted: 30 April 2022 INTRODUCTION Advanced stage ovarian cancer is still associated with the lowest rates of long-term survival especially if complete cytoreduction is not achievable [1]; when it comes to the most frequently encountered causes of suboptimal debulking, the tumoral transformation of the omentum invading the adjacent structures as well as the presence of peritoneal carcinomatosis at the level of the mesenterial lining represent the most commonly incriminated ones [2]. However, once tu- moral omental transformation is encountered, inva- sion of the subjacent loops of the small bowel is com- monly seen and might necessitate extensive enteral resections or might be the cause of incomplete debulking surgery. As expected, not only the small bowel can be involved, but also the other surround- ing viscera such as the colon, the greater gastric cur- vature or the urinary bladder might be invaded [3]. The aim of the current paper is to report the case of a 55 year old patient diagnosed with advanced stage ovarian cancer and omental cake invading the uri- nary bladder in whom multiple resections including a partial cystectomy were performed. CASE REPORT The 55 year old patient with no significant previ- ous medical history self referred for abdominal dis- tension, weight loss and alteration of the general sta- tus; the abdominal ultrasound demonstrated the presence of free peritoneal fluid in association with the presence of disseminated solid tumoral lesions while the biological tests revealed a serum value of CA 125 of 2567 U/ml. The patient was further submit- ABSTRACT Omental cake represents a common finding in advanced stage ovarian cancer and is characterized by the complete omen- tal transformation. Most often it is associated with subjacent invasion of the enteral segments and needs multiple re- sections in order to achieve radical cytoreductive surgery. Meanwhile, in other cases different visceral invasions are encountered necessitating other visceral resections. The aim of the current paper is to report the case of a 55 year old patient diagnosed with stage IIIC ovarian cancer in whom intraoperatively omental cake transformation invading the urinary bladder was encountered. Keywords: ovarian cancer, omental cake, urinary bladder, partial cystectomy