PMC6613033_01
(a) Right lateral and (b) ventrodorsal radiographs of the caudal portion of the abdomen. A large, well-defined, ovoid, soft tissue opaque mass is seen in the right caudal abdominal subcutaneous tissues (white arrows). A large, relatively well-defined, soft tissue opaque mass is noted in the right caudal abdominal cavity (black arrow), caudal to the right kidney (*).
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Radiographic (Super 80CP, Philips Medical Systems, Bothell, WA) findings included two large right caudodorsal abdominal soft tissue opaque masses in close proximity to one another, with evidence of mild fluid streaking of the fat surrounding both structures (Figure 1).
(a) Longitudinal plane sonographic image displaying a well-defined, heterogeneous, non-organ associated abdominal mass with strongly hyperechoic foci within its center, associated with acoustic shadowing (white arrow). (b) Longitudinal plane sonographic image displaying the vascularity of the abdominal mass when interrogated with color Doppler.
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A heterogeneous, non-organ associated abdominal mass with strongly hyperechoic, shadowing foci within its center was identified in the right caudal abdomen (Figure 2(a)). The intra-abdominal mass was moderately vascularized when interrogated with color Doppler (Figure 2(b)), with evidence of multiple relatively large, slightly tortuous, branching intralesional blood vessels.
Postcontrast computed tomographic images of the abdomen on the patient's initial presentation, displayed in soft tissue window. (a) Dorsal oblique multiplanar reconstruction displaying a large, heterogeneously contrast-enhancing, cavitary, non-organ associated abdominal mass (white arrow), caudal to the right kidney (*). A large, rim enhancing, cystic subcutaneous mass ( ) is also noted in the right lumbar subcutaneous tissues, resulting in focal medial displacement of the abdominal wall. (b) Dorsal multiplanar reconstruction displaying the association between the abdominal mass (white arrow) and the right limb of the pancreas ( ). (c) Sagittal multiplanar reconstruction displaying the rim enhancing fistulous tracts (arrowheads) extending in a cranial to caudal fashion in the right hypaxial musculature. (d) Transverse image displaying the rim enhancing fistulous tracts (arrowhead) interconnecting the abdominal mass (white arrow), cystic subcutaneous mass ( ), and hypaxial musculature.
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A well-defined, heterogeneously contrast-enhancing, thick-walled, cavitary, soft tissue attenuating, abdominal mass was present caudal to the right kidney (Figure 3(a)). This mass was confluent with the distal tip of the right limb of the pancreas (Figure 3(b)) and intimately associated with a small intestinal segment. A large, rim enhancing, cystic subcutaneous mass was also identified in the right lumbar subcutaneous tissues, resulting in focal medial displacement of the abdominal wall (Figure 3(a)). In addition, ill-defined, peripherally contrast-enhancing tracts were seen extending through the right hypaxial musculature from the level of the midbody of the L4 vertebra to the level of S3 (Figure 3(c)). Both masses and the peripherally contrast-enhancing tracts in the hypaxial musculature were all interconnected by thick, peripherally contrast-enhancing soft tissue attenuating stalks (Figure 3(d)).
Transverse postcontrast computed tomographic image approximately three months following surgical debridement of a gossypiboma, displayed in a soft tissue window. The soft tissue attenuating mass within the right caudal abdomen (*) has markedly decreased in size and is less contrast-enhancing than prior to surgery with persistence of a non-contrast-enhancing hypoattenuating center. The previously seen large, cystic subcutaneous mass is no longer present.
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The soft tissue attenuating mass within the right caudal abdomen had markedly decreased in size and was less contrast-enhancing, with persistence of a non-contrast-enhancing hypoattenuating center (Figure 4), and few pinpoint, mineral attenuating foci within it.