Introduction/Background We report a case of a 67-year-old patient initially diagnosed with breast cancer in 2002 at our institute.

Right breast mastectomy was performed and progesterone-receptor-negative, oestrogen-receptor-negative, grade 3 invasive ductal carcinoma of no special type identified. The patient received adjuvant chemotherapy and hormonal therapy.

In 2006, a local recurrence in the scar tissue and liver metastases occurred. She received first-line chemotherapy for metastatic disease and partial chest resection.

Methodology In 2007, a contralateral axillary lymph node metastasis was identified, managed with palliative radiation and 6 cycles of second-line chemotherapy, with radiologic complete response achieved.

After ovarian cancer was revealed in 2014, she received primary optimal cytoreduction, with grade 3, FIGO (International Federation of Gynaecology and Obstetrics) stage 2B papillary serous adenocarcinoma identified. Radiologic complete response was attained with 6 cycles of paclitaxel-and-carboplatin adjuvant chemotherapy.

Results In 2017, due to progression, second-line systemic therapy of 6 cycles of paclitaxel and carboplatin was administered, followed by maintenance treatment with Poly (ADP-ribose) polymerase inhibitors (PARPi) (olaparib for 9 months).

Conclusion In February 2022, due to progression she received liposomal doxorubicin-based therapy. After 3 cycles, tests showed partial response, yet treatment was discontinued as pancytopenia occurred. Due to lack of improvement in haematology analysis, secondary acute myeloid leukaemia was diagnosed, subtype M6 according to French-American-British (FAB) classification. The patient received 2 cycles of azacytidine, followed by low-dose cytarabine with cladribine.

Disclosures Further progression in 2019 prompted Hyperthermic Intraperitoneal Chemotherapy (HIPEC) and 6 cycles of platinum-based therapy.

In 2020, she was enrolled in the OReO (Olaparib Maintenance Retreatment in Patients with Epithelial Ovarian Cancer) study, yet the participation was discontinued due to further progression. She received another platinum-based treatment line. After 6 cycles, a tumour was identified at the vaginal stump, managed with radiotherapy (a total dose of 30 Gy in daily fractions of 30 Gy).