RT Journal Article SR Electronic T1 144 A complicated case of paraaortic nodal dissection in a woman with fallopian tube cancer JF International Journal of Gynecologic Cancer JO Int J Gynecol Cancer FD BMJ Publishing Group Ltd SP A201 OP A201 DO 10.1136/ijgc-2021-ESGO.345 VO 31 IS Suppl 3 A1 Iavazzo, CR A1 Fotiou, A A1 Kokkali, K A1 Lekka, S A1 Giannoulopoulos, D A1 Giannakas, P A1 Vorgias, G YR 2021 UL http://ijgc.bmj.com/content/31/Suppl_3/A201.2.abstract AB Introduction/Background*Paraaortic lymph node dissection is a challenging surgical procedure. Recent data mentioned that bulky nodal disease in ovarian/fallopian tube cancer patients stage IIB and above should be dissected in fallopian tube cancer patients that optimal primary cytoreduction has been achieved.Methodology A challenging paraaortic lymph node dissection of a nodal block arising from fallopian tube cancer in a 76 years old patient is presented in this surgical video. Patient has been diagnosed with ovarian/fallopian tube cancer. Her CA 125 was 2161 IU/ml and her preoperative imaging has revealed a mass of right adnexa 7 x 3 cm, a metastatic abdominal mass involving the transverse colon and paraaortic lymph node 6 cm in dimension.Result(s)*Abdominal hysterectomy, omentectomy, resection of the transverse colon, peritonectomies and dissection of the paraaortic nodal mass took place. No macroscopic residual disease was observed at the end of the procedure.Conclusion*Removal of bulky nodal disease is indicated for patients with advanced ovarian/fallopian tube cancer. As applies in any paraaortic/retroperitoneal lymph node dissection resection of bulky lymph nodes can lead in intra or postoperative complications. Therefore, awareness of anatomical landmarks and anatomic variation are of paramount importance.