A 25 year old woman came with abdominal discomfort for a month
Transabdominal ultrasonography of the pelvis shows a well defined, heterogeneously hypo to isoechoic lesion approximately 8 x 7cm in the left adnexa. There is posterior acoustic shadowing - deeper structures are obscured, the “tip of iceberg sign”. There are numerous echogenic foci and linear strands within the lesion - the “dot dash pattern”.