OBJECTIVE: The purpose of this pictorial essay is to review the differential considerations when an adnexal mass is detected on CT or MRI in a patient with a primary nonovarian malignancy.
CONCLUSION: Such adnexal masses may be metastases to the ovaries, primary ovarian malignancy, or incidental benign disorders. Solid masses are more likely metastases, but metastases can be predominantly cystic and primary ovarian cancers can be solid. MRI may help characterize incidental benign entities such as endometriosis, fibroma, and peritoneal inclusion cysts.