Primary Peritoneal Carcinoma Mimicking Ovarian Cancer on Imaging

Primary peritoneal carcinoma, histologically identical to high-grade serous ovarian carcinoma, can present with diffuse peritoneal disease and normal ovaries. When cytology suggests ovarian origin but imaging shows no adnexal mass, scrutinize the peritoneum.

• Primary peritoneal carcinoma is biologically and histologically nearly identical to high-grade serous ovarian carcinoma.
• Typical imaging: diffuse peritoneal nodularity and malignant ascites with normal-appearing ovaries.
• Mismatch between pathology suggesting ovarian origin and imaging without an ovarian mass should trigger reevaluation of peritoneal findings.

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