PMC6159271_01
(a and b) Ultrasound with power Doppler imaging shows bilateral complex ovarian masses. OV, ovarian.
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On screening the adnexal regions, bilateral highly vascular complex adnexal masses were identified, measuring 8 x 6 cm2 on the right side and 12 x 8 cm2 on the left side (Figure 1).
Transvaginal ultrasound with power Doppler imaging shows a bulky highly vascular cervix (a) and polypoidal masses seen in the upper vagina. (b) Peritoneal deposits are seen in the Douglas pouch (arrow).
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Solid peritoneal deposits were also identified in the Douglas pouch (Figure 2).
T2 weighted coronal (a) and sagittal (b) images show bilateral complex cystic mass lesions (straight arrows) and upper vaginal mass (curved arrow). A noteworthy feature is the fetal parts (asterisks).
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T2 weighted images showed findings matching those of the preliminary pelvic ultrasound imaging (Figure 3).
(a) Diffusion-weighted images show restricted diffusion in the upper vaginal mass (arrow). (b) Apparent diffusion coefficient map shows intermediate signal intensity and low ADC value by the applied ROI. These findings add to the sugesstion of malignancy in the vaginal mass.
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On the DWI sequence, the masses showed restricted diffusion in the form of persistent bright signal intensity and low apparent diffusion coefficient (ADC) values, which strongly favoured likely malignant pathology (Figure 4).