Metastatic colonic adenocarcinoma simulating primary ovarian neoplasm in transvaginal Doppler sonography.

Transvaginal color flow and pulsed Doppler sonography has shown promise in the evaluation and characterization of adnexal masses and may ultimately play a role in ovarian cancer screening.',' A relative increase in the diastolic flow in malignant lesions has been previously reported. Pathologic evidence suggests that this phenomenon reflects the paucity of smooth muscle within tumor vessels along with intratumoral arteriovenous We present a case of a postmenopausal woman who presented with large adnexal masses simulating primary ovarian neoplasm in gray-scale sonography that, in addition, manifested an abnormally low resistive index in the transvaginal Doppler examination. Further evaluation with computed tomography (CT) and, ultimately, laparotomy revealed metastatic spread of a mucinous adenocarcinoma of the colon to the adnexa.