Diagnostic Ultrasound - Abdomen and Pelvis

Serous Ovarian Cystadenoma/Carcinoma
(Left) Transabdominal
grayscale ultrasound of a
unilocular adnexal mass in a
28-year-old patient shows
suspicious papillary
projections along the wall
of the otherwise cystic lesion.
(Right) Color and pulsed
Doppler ultrasound helps to
prove vascularity in the solid
component and exclude
hematoma. In this case,
pathology showed papillary
serous borderline tumor.
Diagnoses: Female Pelvis
(Left) Abundant solidappearing
material is present
in this complex mixed solid
and cystic ovarian mass st;
however, there is no
detectable internal vascularity
on this power Doppler
ultrasound. (Right) Axial CECT
of the same mass shows
multiple septations and
pelvic free fluid st. Pathology
showed serous cystadenoma
with necrosis due to torsion.
(Left) The presence of ascites
is very concerning for
metastatic disease. When free
fluid is identified ſt, close
examination should be
performed to assess for
peritoneal implants. None
were found in this case. (Right)
In most cases ovarian masses
are removed without rupture
of the cyst to prevent
contamination of the
peritoneum. Typically, soft
tissue and node biopsies are
obtained at the time of
surgery, as well as pelvic
peritoneal washings for
cytology.
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