12th May 2024

A 60-year-old woman presents with persistent pelvic pain, bloating, and recent onset of urinary urgency.

A 60-year-old woman presents with persistent pelvic pain, bloating, and recent onset of urinary urgency. Her medical history includes infertility and endometriosis. A pelvic ultrasound reveals bilateral ovarian masses, and a CA-125 level is markedly elevated. During exploratory laparotomy, biopsies confirm a diagnosis of mucinous ovarian carcinoma. Imaging post-surgery shows metastatic deposits in the omentum.

Which is the most likely route by which this tumour spread to the omentum?