PMC9396543_01
Portal phase, enhanced computed tomography of 67-year-old man, admitted to the Emergency Department with abdominal pain. Portal scans of the abdomen and pelvis shown in the right iliac fossa (A), a mass with moderate enhancement, measuring 7 cm, with hypodense areas. This mass had well-defined margins and appeared in contact with the ilium and vessels, but it did not infiltrate them. Another similar mass (B) appeared in the pelvic cavity in contact with the ileum; it measured a maximum diameter of 9 cm; this mass was also expansive but did not infiltrate adjacent structures. Other multiple smaller masses (C) were found on the right and left flank with maximum diameters of 3 cm. Multiple nodular pericentimetric formations (D) were present in the spleen, which were slightly hypodense.
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F1
These were characterized by moderate enhancement, rare hypodense areas due to the presence of necrotic- or cystic-changes, with focal spots of hemorrhages, and well-defined margins (Figure 1).
PET/CT with 18F-FDG. PET/CT shows that all lesions (A,B) had intense metabolic activity; however, the splenic nodular areas (C) did not pick up FDG.
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F2
Surgical findings with imaging correlation. (A) Complete removal of the 7-cm mass is shown in the right iliac flank, close to the superior mesenteric vessels; (B) Centimetric omental mass was removed and analyzed by extemporaneous histological examination; (C) 9-cm mass (shown at CT in the pelvis) removed with segmental ileal loop resection to perform an en-bloc removal; (D) 4-cm mass in the left iliac region was completely removed.
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F3
All visible masses were completely removed, taking care to avoid tumor rupture (Figure 3).