Sir,I read the recent rare case report on primary ovarian cancer by Panda et al. with a great interest.[1] According to this report, some critical concerns on the diagnosis of primary ovarian cancer should be mentioned. Panda et al. made a conclusion that “now, with ultrasonographic advances, it can be diagnosed early, leading to conservative treatment and preservative surgery.”[1] Indeed, the role of ultrasonography for the detection of ectopic pregnancy is of no doubt. However, its role for specific diagnosis of primary ovarian pregnancy is still questionable. Only a gestation sac in adnexa area, which cannot definitely diagnose of primary ovarian pregnancy, is the common ultrasonographic finding.[2] The actual diagnosis is usually due to the confirmation by histopathological study. The ultrasonography could only help early detect the ectopic pregnancies, of which, only a few can be primary ovarian pregnancy.