Complex Ovarian Mass on Ultrasonography: Primary or Metastatic Tumor?

To the Editor: We read with interest the case record discussed by Dr. Francis M. Ingersoll (N Engl J Med 292:521, 1975). In this 70-year-old woman metastatic ovarian adenocarcinoma was of colonic origin. Ultrasound evaluation of the lower abdomen revealed a large, complex mass containing cystic and solid elements. Dr. Ingersoll asks about the reliability of ultrasonographic differentiation between primary and metastatic ovarian tumors. Dr. Stone's response was somewhat of a surprise to us: “in our experience it has been unusual to observe a highly complex mass. that proves to be a primary ovarian tumor. Although these tumors can. . . No extract is available for articles shorter than 400 words.