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Updated on December 20, 2024

A Large Adnexal Mass in a Patient with Endometrial Cancer

Clinical History

A 74-year old lady presented with abdominal distension and discomfort.

Case Description

Ultrasound of the abdomen and pelvis (TA and TV) revealed a grossly thickened endometrium measuring 27 mm in AP calibre with heterogeneous echotexture. In addition there was a 131 mm complex non-vascular cystic mass (endometrial cancer) in the left adnexa/ left hemipelvis.

Diagnosis/ Discussion/ Treatment/ Follow up

The patient had a whole body contrast CT which confirmed the ultrasound findings (endometrial cancer) in addition to the diagnosis of some omental cake with nodal peritoneal deposits and ascites in keeping with gynaecological malignancy. The adnexal cyst appeared to herniate through the left inguinal canal.

The tumour markers (Ca125 and Ca19.9) were significantly elevated.

Subsequently, the patient had an omental biopsy which confirmed metastatic high grade carcinoma.

Sonograms

Transabdominal view of the pelvis showing a 131 mm x 68 mm (L x AP) heterogeneous cystic mass (endometrial cancer)in the left adnexa
Transabdominal view of the pelvis showing a 131 mm x 68 mm (L x AP) heterogeneous cystic mass in the left adnexa
Transvaginal longitudinal view of the uterus showing an abnormally thickened endometrium of 26 mm (AP)
Transvaginal longitudinal view of the uterus showing an abnormally thickened endometrium of 26 mm (AP)
Power Doppler imaging of the left adnexal complex cyst showing no evidence of internal vascularity
Power Doppler imaging of the left adnexal complex cyst showing no evidence of internal vascularity
PDI of the left adnexal cystic mass
PDI of the left adnexal cystic mass
Free fluid in the right upper quadrant in keeping with ascites
Free fluid in the right upper quadrant in keeping with ascites
Ascites in the left upper abdominal quadrant adjacent to the spleen; subphrenic and within the splenorenal recess
Ascites in the left upper abdominal quadrant adjacent to the spleen; subphrenic and within the splenorenal recess
Ascites in the LUQ
Ascites in the LUQ
Axial CT showing the cyst in the LIF
Axial CT showing the cyst in the LIF
Sagittal CT showing the left adnexal cystic mass herniating into the left inguinal canal
Sagittal CT showing the left adnexal cystic mass herniating into the left inguinal canal

Published on: September 25, 2024

Author

Sonohive

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A Large Adnexal Mass in a Patient with Endometrial Cancer

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