Diagnostic Ultrasound - Abdomen and Pelvis

Solid Adnexal Mass
Differential Diagnoses: Female Pelvis
(Left) Transverse endovaginal
US in the same patient shows
the pedunculated fibroid ſt
projecting into the right
adnexa with a broad based
stalk st connecting it to the
uterine body . (Right)
Transverse transabdominal US
shows a large, heterogenous,
echogenic mass ſt in the left
adnexa surrounding a small
cystic component st. The
patient was 7 weeks pregnant
by LMP and no IUP was seen. A
large clot surrounding a
ruptured tubal ectopic was
confirmed at surgery.
Leiomyoma
Ectopic Pregnancy
(Left) Endovaginal US in a 19-
year-old woman with a pelvic
mass on exam shows a large,
complex, heterogeneous mass
(calipers) with echogenic
Rokitansky nodule ſt, dotdash
sign st from hair, and
echogenic fluid. This is the
most common ovarian tumor
and should not be mistaken
for carcinoma. (Right)
Longitudinal endovaginal US
in a 34-year-old woman with
acute pain shows an enlarged,
6 cm, heterogeneous ovary
with peripheral follicles ſt.
Echogenic free fluid is present
st, not uncommonly seen.
Mature Teratoma (Dermoid)
Adnexal Torsion
(Left) Transverse
transabdominal US in a 45-
year-old woman with colon
cancer shows bilateral adnexal
masses, solid on the right ſt
and predominately cystic on
the left . (Right) Axial CECT
in the same patient shows an
enhancing solid right adnexal
mass ſt and a mixed cystic
and solid left adnexal mass st,
pathologically confirmed to be
metastatic colon cancer.
Ovarian metastases are often
bilateral, large, and
heterogeneous.
Metastases, Ovary
Metastases, Ovary
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