A passerby found the body of 41-year-old Sandra Denise Thomas March 29 on Lawrence Street between Jones and Holland Glen streets.
The medical examiner's report say the official cause of death is undetermined, but says Thomas could have bled to death or asphyxiated.
Her mutilated body was found face down in a muddy ditch.
Family members told ABC11 Eyewitness News in March that Thomas lived near the neighborhood where she was found.
The ME's report says she "was last known to be alive when she was leaving a gathering at a nearby residence several hours prior to her body being discovered."
The report says cocaine was found in Thomas' system and foul play is likely.
"The complexity of these injuries and the scene findings suggests that some other person or vehicle may have been involved with this death," says the report.
Fuquay-Varina Police have no suspect information or arrest information at this time. Currently, police are pursuing leads in the case.
There is a substantial reward for information leading to the arrest of a suspect. If you have information that may help in the investigation, please contact Detective Sergeant Jeff Wenhart at 919-753-1006.