Background: Being highly malignant, ovarian carcinoma mostly presents at an advanced stage at the time of diagnosis. The appendix could be a potential site for metastatic involvement by ovarian malignancy, however, this is a rare event. Though, its presence can upgrade the tumor to stage III. Case Presentation: We report a post-menopausal patient with abdominal mass and distension. Computed tomography scan showed bilateral adnexal lesions, an enlarged enhancing appendix, right hydroureteronephrosis, and ascites. On histopathological correlation, the adnexal lesions turned out to be moderate to poorly differentiated papillary adenocarcinoma with omental and appendiceal involvement by the pathologic process. The patient was then referred to the Oncology department. Conclusion: Clinical assessment of appendix or routine appendectomy as part of late-stage ovarian carcinoma management in older patients with omental involvement can lower the risk of appendiceal involvement with subsequent downstaging of the tumor.

Keywords: Ovarian carcinoma, appendiceal metastasis, appendectomy.