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.