PMC6180867_01
Axial (a) and coronal (b) contrast-enhanced CT images of the abdomen reveal a large solid cystic mass lesion with an intensely enhancing solid component seen in the right upper abdomen in the subhepatic location (long arrows in a and b). The lesion is seen separately from the gallbladder (short arrow in b). The lesion also shows evidence of loss of fat planes with the adjacent anterior abdominal wall suggesting invasion.
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fig1
This was followed by a contrast-enhanced CT scan of the abdomen that revealed a large (approximately 7 x 6 cm sized) solid cystic mass lesion in the right subhepatic region showing intensely enhancing solid areas with peripheral cystic non-enhancing areas (Figure 1a,b).
Axial (a) and coronal (b) maximum intensity projection contrast-enhanced CT image of the abdomen shows a dilated omental vein (arrows) draining the mass lesion into the superior mesenteric vein, thereby depicting the "omental vascular pedicle sign" and suggesting an omental origin of the mass lesion. The mass was excised and histopathology revealed it to be a malignant peripheral nerve sheath tumour of the greater omentum.
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fig2
Arterial supply to the mass was from a branch of the right gastroepiploic artery, while venous drainage was via the superior mesenteric vein through the right gastroepiploic vein (Figure 2).