Ascites and adnexal masses: not always ovarian or tubal carcinoma

A 32-year-old Mozambican woman presented to the hospital with progressive abdominal distension, pelvic pain and low-grade fever (38°C). Her family history was significant for one sister with breast cancer at the age of 40 years. In the diagnostic assessment, cancer antigen 125 (CA-125) was highly elevated (950 U/L) and the pelvic MRI showed bilateral tubal enlargement, right suspicious ovarian cyst and diffuse mesenteric thickening, A diagnosis of ovarian/tubal carcinoma with peritoneal carcinomatosis was suspected. Diagnostic laparoscopy revealed high volume ascites, bilateral tubal enlargement …