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Peritoneal Metastasis

Ly JL - MedPix

View Article: MedPix Image - MedPix Case

Affiliation: Wilford Hall USAF Medical Center

ABSTRACT

Diagnosis: Peritoneal Metastasis

History: 62-year-old African American female presents with diffuse abdominal pain and bloating. bHCG was negative.

Findings: CT FINDINGS: There is a significant amount of ascites within the abdomen extending down into the pelvis where a heterogeneous and calcified mass is identified. This is in the area near the uterus and probably represents a fibroid uterus, although there is a lot of streaking artifact limiting visualization of the structures in the pelvis. There is fluid surrounding this calcified heterogeneous mass without definite identification of the ovaries; ovarian mass cannot be excluded. Within the upper abdomen, there is the appearance of omental caking concerning for metastatic process, seeding the greater omentum; ovarian malignancy is most common cause of this finding and is suspected in this older female patient. US FINDINGS: The uterus is enlarged measuring 9.97 x 6.65 x 8.96 cm and has a heterogeneous appearance consist with a fibroid uterus, which was suspected on recent CT. There is a 4.9 x 4.1 x 6.3 cm anterior myometrial fibroid identified. There is a marked amount of free-fluid noted within the pelvis. The left adnexa /ovary is not well seen. Within the right adnexal region, the right ovary is visualized and is enlarged measuring 4.75 x 3.65 x 4.2 cm, and contains a complex cystic mass measuring 2.6 x 2.5 x 3.3 cm. This mass contains numerous septations some of which are irregular and thickened. There is no significant blood flow within the mass. The right ovary itself demonstrates normal arterial and venous blood flow and spectral Doppler analysis.

Ddx: Ovary Colon Stomach Pancreas

Exam: She was afebrile with stable vital signs and a normal white blood count. Exam showed a diffusely distended nonacute abdomen and enlarged uterus by palpation. There was clinical concern for bowel obstruction. Contrast-enhanced CT of the abdomen/pelvis was obtained as the initial imaging study and was followed with a pelvic US.

No MeSH data available.


Sagittal grey-scale sonographic image shows a large right ovarian cystic mass and solid mass containing several irregular, thick septations.
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MPX1928_synpic17866: Sagittal grey-scale sonographic image shows a large right ovarian cystic mass and solid mass containing several irregular, thick septations.


Peritoneal Metastasis

Ly JL - MedPix

Sagittal grey-scale sonographic image shows a large right ovarian cystic mass and solid mass containing several irregular, thick septations.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1928&req=5

MPX1928_synpic17866: Sagittal grey-scale sonographic image shows a large right ovarian cystic mass and solid mass containing several irregular, thick septations.

View Article: MedPix Image - MedPix Case

Affiliation: Wilford Hall USAF Medical Center

ABSTRACT

Diagnosis: Peritoneal Metastasis

History: 62-year-old African American female presents with diffuse abdominal pain and bloating. bHCG was negative.

Findings: CT FINDINGS: There is a significant amount of ascites within the abdomen extending down into the pelvis where a heterogeneous and calcified mass is identified. This is in the area near the uterus and probably represents a fibroid uterus, although there is a lot of streaking artifact limiting visualization of the structures in the pelvis. There is fluid surrounding this calcified heterogeneous mass without definite identification of the ovaries; ovarian mass cannot be excluded. Within the upper abdomen, there is the appearance of omental caking concerning for metastatic process, seeding the greater omentum; ovarian malignancy is most common cause of this finding and is suspected in this older female patient. US FINDINGS: The uterus is enlarged measuring 9.97 x 6.65 x 8.96 cm and has a heterogeneous appearance consist with a fibroid uterus, which was suspected on recent CT. There is a 4.9 x 4.1 x 6.3 cm anterior myometrial fibroid identified. There is a marked amount of free-fluid noted within the pelvis. The left adnexa /ovary is not well seen. Within the right adnexal region, the right ovary is visualized and is enlarged measuring 4.75 x 3.65 x 4.2 cm, and contains a complex cystic mass measuring 2.6 x 2.5 x 3.3 cm. This mass contains numerous septations some of which are irregular and thickened. There is no significant blood flow within the mass. The right ovary itself demonstrates normal arterial and venous blood flow and spectral Doppler analysis.

Ddx: Ovary Colon Stomach Pancreas

Exam: She was afebrile with stable vital signs and a normal white blood count. Exam showed a diffusely distended nonacute abdomen and enlarged uterus by palpation. There was clinical concern for bowel obstruction. Contrast-enhanced CT of the abdomen/pelvis was obtained as the initial imaging study and was followed with a pelvic US.

No MeSH data available.