62-year-old woman, two pregnancies with natural delivery, operated on in the past for uterine fibroids; does not take chronic drugs; has been going to my clinic for a general malaise associated with a globular abdomen for several months despite a strict diet, followed monthly by a nutritionist; the woman shows recent haematological evidence of alteration of tumor markers, in particular of CA 125 (CEA 8.10, CA 15.3 215.10, CA 125 1215, CA 19.9 0.20). I then perform an abdominal ultrasound, identifying in the context of a modest ascitic effusion involving all the abdominal recesses a right adnexal mass magnified by the effusion of about 36x26mm, equipped with its own vascularization of an aberrant type, and solid plastron of the meso-hypogastric peritoneum with a maximum thickness of 36mm, of the type omental cake, with hypoechoic peripheral solid nodulation of about 12mm. Uterus basically within limits. In this context, some small hypoechoic nodules of the left hepatic lobe were also highlighted, the largest of about 4 mm at the margin of the III L and 6 mm at the level of the IV L, suggestive of secondary symptoms. Voluminous pathological lymph node of about 18mm in the hepatic hilum.