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case_images: Ultrasonography (USG).. Ultrasonography revealed a midline thick-walled adnexal cyst measuring 11 x 10 cm with internal septation.
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case_images: The uterus appeared normal in size (Fig. 1).
case_images: CT-Scan abdomen.. CT imaging demonstrated a large left adnexal thick-walled, multiloculated, incomplete septations of 12 x 10 x 11cm, suggestive of a tubo-ovarian abscess or neoplastic lesion.
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case_images: CT imaging demonstrated a large left adnexal thick-walled, multiloculated, incomplete septations of 12 cm x 10 cm x 11 cm, suggestive of a tubo-ovarian abscess or neoplastic lesion (Fig. 2).
case_images: Adherent left tubo-ovarian mass observed during laparotomy.
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case_images: During staging laparotomy, the left tubo-ovarian mass was found to be adherent to the urinary bladder, anterior wall of the uterus, and bowel, making further dissection challenging (Fig. 3).
case_images: Histopathologic imaging showing the presence of lipid-laden macrophages and chronic inflammatory cells.
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case_images: The resected tubo-ovarian mass and pus culture were sent for histopathological evaluation (Fig. 4).