Presentation
History withheld
Patient Data

Multilocular cystic-solid mass in the right ovary measuring 41 x 30 x 57mm. It contains a solid component measuring 28 x 14 x 30 mm which is has moderate internal vascularity (IOTA color score 2-3) and 1-2 smaller papillary projections.
A discrete hypervascular nodule is seen in the pouch of Douglas, highly concerning for peritoneal metastasis.
Normal uterus and left ovary. No ascites.
Case Discussion
Patient had initially presented with a breast lesion, with histological diagnosis suggestive of metastatic disease of gynecological origin. She had no pelvic symptoms.
At resection of the adnexal mass, histologic diagnosis was high grade serous ovarian adenocarcinoma.
Subsequent PET/CT (not shown) confirmed nodular peritoneal metastases, as well as nodal and chest wall metastases.