Presentation
Lower abdominal pain and heaviness.
Patient Data
A well-defined solid mass lesion was found in the right ovary juxtaposition to the right fallopian tube measuring about 6.5 x 7 cm.
Color flow shows vascularity (RI - 0.4).
The gross intraperitoneal collection is noted. Some small nodular lesions are also noted abutting the peritoneum, indicating metastatic deposits (peritoneal carcinomatosis).
Cytopathology report
Microscopic findings: moderate cellular smears consist of atypical epithelial cells arranged in overlapping clusters, glands, and singly. These cells have hyperchromatic nucleus with prominent nucleoli and a moderate amount of cytoplasm.
Comment: positive for malignant cells favoring adenocarcinoma.
Case Discussion
Post-menopausal women was diagnosed with a pelvic mass with a low resistive index on color Doppler,
< 0.4 indicating high vascularity which favors malignant mass.
There was also a significant amount of intraperitoneal collection and nodular lesions at the border of the peritoneum indicating seeding at the time of diagnosis.
The patient underwent USG guided biopsy which reveals adenocarcinoma.
The tumor markers for ovarian cancer were also elevated.
Carcinoembryonic antigen (CEA) level was 283 ng/ml which is clearly well above the normal range. The normal reference range is up to 5 ng/dl.
Possibility of metastatic adenocarcinoma has been ruled out.
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