The 20-year latency: transformation of a remote Müllerian tumour to low-grade serous carcinoma within an incisional hernia.

Low-grade serous carcinoma (LGSC) is known for its indolent course and potential for late recurrence, often decades after initial surgery. We present the case of a 62-year-old female who was incidentally found to have LGSC consistent with a delayed Müllerian neoplastic recurrence during an incisional hernia repair, 20 years after her primary gynecologic surgery. This case highlights the phenomenon of extremely delayed recurrence and underscores the need for long-term surveillance and a high index of suspicion for malignancy in patients with a remote history of gynecologic tumors, even when they present with common surgical problems.