•TP53 variant negative high-grade serous ovarian cancer is rare and can still show p53 abnormal immunohistochemistry.•Diagnostic and therapeutic considerations include pathologic, molecular and clinical domains.•Genetic reassessment through more comprehensive assays should be considered to ensure no missed rare or complex variants.•Presence of BRCA mutations can occur in TP53 variant high-grade serous ovarian cancer.
Keywords: Diagnosis; High grade serous ovarian cancer; Next generation sequencing; P53 immunohistochemistry; TP53 variant negative.
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