Diagnostic Ultrasound - Abdomen and Pelvis

Ovarian Metastases Including Krukenberg Tumor
(Left) Sagittal transvaginal US
in a 63-year-old woman with
history of rectal cancer shows
an enlarged mixed solid and
cystic right ovarian mass ſt.
(Right) Longitudinal
endovaginal US shows a large
solid adnexal mass in a patient
with gastric cancer. Note the
small foci of calcification st,
which can rarely be seen in
mucinous gastric
adenocarcinomas.
Diagnoses: Female Pelvis
(Left) Axial CECT in a 61-yearold
woman undergoing
restaging CT for colon cancer
shows a heterogeneous
adnexal mass ſt anterior to
the uterus . The mass
contains foci of high density
suggesting blood products.
Note the normal left ovary st.
(Right) Transabdominal US in
the same patient shows a
multiseptated cyst without
obvious large solid
component. Although the
imaging could represent a
hemorrhagic cyst, this would
be unusual in a
postmenopausal woman.
(Left) Endovaginal color
Doppler US in the same
patient better shows solid
irregular components st of
the complex cystic mass that
have little color Doppler
signal. (Right) Image from USguided
percutaneous fine
needle aspiration shows
needle ſt in the most
heterogenous solid
component. Cytology showed
malignant cells consistent
with metastatic colon cancer.
Percutaneous biopsy is not
typically used to diagnose
suspicious adnexal masses but
is appropriate in cases of
suspected metastatic disease.
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