A 40-year-old woman, gravida 3, para 3, with last menstrual period two weeks ago presents for evaluation of a palpable pelvic mass. She reports noticing a slow increase in her abdominal distention over the last four months; however, she denies abdominal pain. She denies any bowel or bladder dysfunction. She is sexually active and denies dyspareunia. Her sexual partner has had a vasectomy. She denies a personal history of breast cancer and denies any family history of breast, ovarian, or colon cancer. Her medical history is significant for anxiety. She has no past surgical history. She is currently taking citalopram. She has no know drug allergies.