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Tafti D, Krause K, Dillon R, Flores R, Cecava ND. Sigmoid cancer mimicking ovarian echotexture on transvaginal ultrasound: Case report with literature review. Radiol Case Rep 2020; 15:2482-2492. [PMID: 33014234 PMCID: PMC7522440 DOI: 10.1016/j.radcr.2020.09.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/15/2020] [Accepted: 09/20/2020] [Indexed: 11/29/2022] Open
Abstract
Ultrasound is a first line imaging modality for the evaluation of female pelvic pain. Pelvic pain constitutes one of the most common reasons for presentation to the emergency department with increasing use of point of care ultrasound. Infrequently, point of care or formal ultrasound evaluation may lead to misdiagnosis of extraovarian disease. This can have serious consequences, especially if an extraovarian malignancy is mistaken for a normal ovary or an ovary with a benign process. We present a case of a 41-year-old female who presented to the emergency department for a chief complaint of pelvic pain and vaginal bleeding. Transvaginal ultrasound demonstrated a left adnexal mass, later characterized as a sigmoid colon cancer on MRI and pathology, simulating ovarian echotexture with peripheral hypoechoic components resembling follicles. This article will review the literature of various cases of extraovarian pathology misidentified as ovarian processes and highlight the importance of considering these extraovarian mimickers to prevent potential morbidity and mortality of a missed diagnosis.
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Affiliation(s)
- Dawood Tafti
- Department of Radiology, Brooke Army Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, San Antonio, TX, 78234, USA
| | - Katherine Krause
- Department of Pathology, Brooke Army Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, San Antonio, TX, 78234, USA
| | - Rebecca Dillon
- Department of Radiology, Brooke Army Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, San Antonio, TX, 78234, USA
| | - Rebecca Flores
- Department of Radiology, Brooke Army Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, San Antonio, TX, 78234, USA
| | - Nathan D Cecava
- Department of Radiology, Brooke Army Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, San Antonio, TX, 78234, USA.,Uniformed Services University of Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814, USA.,Texas A&M School of Medicine, 8447 Riverside Pkwy, Bryan, TX 77807, USA
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Ohngemach DJ, Esterson YB, Rahman N, Noor A, Pellerito JS. Unexpected Findings During Evaluation of Acute Pelvic Pain With Transvaginal Sonography. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:2687-2696. [PMID: 27821650 DOI: 10.7863/ultra.16.02015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 02/29/2016] [Accepted: 03/23/2016] [Indexed: 06/06/2023]
Abstract
Transvaginal sonography is the first-line imaging modality used to evaluate acute female pelvic pain in the emergency setting because of its accessibility, lack of ionizing radiation, and excellent ability to identify reproductive tract disorders. Although the intent of transvaginal sonography is to evaluate the reproductive organs, imaging of adjacent pelvic structures is an important part of every transvaginal sonographic examination. Gastrointestinal, urologic, and vascular disorders incidentally scanned on transvaginal sonography may explain the pain for which the examination is being performed. In such cases, transvaginal sonography may play an important role in the diagnostic process if the clinician is aware of the transvaginal sonographic appearance of these entities.
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Affiliation(s)
- Daniel J Ohngemach
- Department of Radiology, Northwell Health System, Hofstra Northwell School of Medicine, Manhasset, New York USA
| | - Yonah B Esterson
- Department of Radiology, Northwell Health System, Hofstra Northwell School of Medicine, Manhasset, New York USA
| | - Naeem Rahman
- Department of Radiology, Northwell Health System, Hofstra Northwell School of Medicine, Manhasset, New York USA
| | - Ali Noor
- Department of Radiology, Northwell Health System, Hofstra Northwell School of Medicine, Manhasset, New York USA
| | - John S Pellerito
- Department of Radiology, Northwell Health System, Hofstra Northwell School of Medicine, Manhasset, New York USA.
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