Which finding may indicate advanced ovarian cancer?

• A. Ascites and abdominal distention
• B. Sister Mary Joseph nodule
• C. Pelvic inflammatory disease
• D. Ovarian torsion

Answer: (C)

A finding that indicates advanced ovarian cancer is ascites with abdominal distention. When ovarian cancer spreads to the peritoneum, malignant fluid accumulates in the abdominal cavity, producing ascites. The buildup of fluid plus the tumor burden stretches the abdominal wall, leading to noticeable distention. This pattern reflects widespread peritoneal involvement and is a classic clue to late-stage disease.

A Sister Mary Joseph nodule can occur with metastatic spread to the umbilicus and may accompany advanced cancer, but ascites with distention is a more common and direct sign of advanced ovarian cancer. Pelvic inflammatory disease is an infectious process, and ovarian torsion is an acute condition causing sudden pain—not a marker of cancer progression.