The synchronous occurrence of breast and ovarian cancers within individual omental metastases has not been reported in the available medical literature. We report such a finding in a patient with previously diagnosed invasive lobular carcinoma of the right breast. After 5 years of surveillance and disease-free interval, there was development of ovarian cancer, ascites and peritoneal metastases. Ultrasound-guided biopsy of a peritoneal metastasis confirmed dual histology from breast and ovarian carcinoma. Despite the presence of a prolonged disease-free survival from the primary breast cancer, the subsequent finding of advanced ovarian cancer highlights the potential diagnostic and therapeutic dilemmas which persist in the management of these patients.

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