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A 70-year-old female patient with a previous history of hysterectomy and adnexectomy presented with a large pelvic
mass. CA-125 was obtained and was found to be elevated (240 U/mL). CEA and CA19-9
were within normal limits (11 U/mL and 2.1 ng/mL, respectively). Computed tomography
(CT) of the abdomen and pelvis with oral and intravenous contrast revealed a diffuse,
nodular, ill-defined infiltrating mass with innumerable calcifications in the greater
omentum filling the peritoneal cavity suggesting peritoneal carcinomatosis (Fig 1). There was infiltrative involvement of the mesentery of the small bowel and transverse
and sigmoid colon's with perivascular encasement and thickening of the wall of the
sigmoid colon (Fig 2). Ultrasound needle-guided biopsy revealed fat necrosis without evidence of malignancy.
Flexible sigmoidoscopy was performed and revealed narrowing of the sigmoid colon 35
cm from the anal verge.
Fig 1Axial CT of the abdomen with oral and intravenous contrast at the level of the kidneys
showing infiltrating mass in the left side of the greater omentum with scattered calcifications
(white arrow) and infiltrating mass in right side of the transverse mesocolon with perivascular
encasement (black arrow).
Fig 2Axial CT of the pelvis showing an infiltrating mass in right side of small bowel mesentery
with perivascular encasement (white arrow) and infiltrating mass in sigmoid mesentery with scattered calcifications (black arrow).
This section features outstanding photographs of clinical materials selected for their educational value or message, or possibly their rarity. The images are accompanied by brief case reports (limit 2 typed pages, 4 references). Our readers are invited to sumit items for consideration.
