Unveiling the nature of a peritoneal implant using endoscopic ultrasound

Ovarian cancer is one of the leading causes of cancer deaths in women with a median age of diagnosis of 63. Commonly, late presentation leads to advanced disease with peritoneal involvement. Often, ovarian cancer recurs even after extensive surgical interventions and oncological therapy. Below, we present a case of a 75-year-old women with past surgical history of ovarian carcinoma who underwent debulking surgery and adjuvant chemotherapy treatment. During gynecological oncology follow-up positron emission tomography (PET-CT) scan she was diagnosed with fluorodeoxyglucose (FDG) uptaking, 12 mm lesion in the serosal surface of the recto-sigmoid junction. Due to the uncommon site of the lesion and its unknown histological nature, the lesion was biopsied during trans-rectal endoscopic sonography which held bases for further surgical intervention.