Ultrasound
Complex and diffusely hetero-echogenic tumoural enlargement of the right and left ovaries, both composed of solid and cystic parts and both predominantly matted/showing a kissing tendency at their para-medial areas, is noted. The right ovary measures approximately 556 ml, while the left ovarian counterpart measures approximately 853 ml in volume. Colour Doppler mapping shows subtle vascularity within the lobulated ovarian lesions.
Within the pelvic floor, a lobulated, large (8.6 x 5.44 cm) hypoechoic and hypovascular solid material seats and displaces the uterus superiorly. The anteverted and non-gravid uterus is normal and measures 30.2 ml in volume with no focal myometrial, endometrial, or cervical lesions. The endometrial stripe thickness of 0.42 cm noted is within normal limits.
Moderately clear ascites fill the potential intra-abdominal spaces and exhibit septations on the right lumbar region. Small, multiple enlarged para-aortic lymph nodes are noted. Again, a small-sized (3.33 x 2.3 cm) hypoechoic and lobulated solid lesion is noted at the left liver lobe inferno-medially at the level of the superior caudate lobe parenchyma, which could be hepatic metastasis. The gallbladder shows a thin-walled outline, albeit with multilobular intra-luminal hypoechogenic soft-solid material.