SUBJECTIVE:• 63 y/o, female• Epigastric pain• Vomiting• Weight loss• Early satiety• Easy fatigability

OBJECTIVE:• CT scan: gastric mucosal

thickening• (+)pallor• Pale palpebral conjunctiva• (+) bulging flanks• (+) epigastric tenderness• (+) shifting dullness• (+) fluid wave• (-) succusion splash• (+) soft 1x1 cm mass, above

the pectinate line, 12 o’ clock position, non-tender

SALIENT FEATURES

• Abdominal pain• Weight loss and satiety• Previous biopsy and

endoscopy findings

• Abdominal pain• Weight loss and satiety• Worsening of symptoms

despite CaCO3• Ascites and abdominal mass• CT scan

Benign or Malignant?

CT SCAN: 11/21/09

CT SCAN: 11/21/09

CT SCAN: 11/21/09

CT with contrast of the abdomen

Normal CT with contrast of the abdomen Patient’s CT with contrast (Nov 2009)

Discussion

CT with contrast of the abdomen

Normal CT with contrast of the abdomen Patient’s CT with contrast (Nov 2009)

Metastatic breast

cancer to the

stomach with a

linitis plastica

appearance on

CT. MDCT image

in an elderly

woman with

metastatic breast

carcinoma and

early satiety

shows marked

thickening of the

wall of the gastric

antrum (arrows).

The radiographic

findings are

indistinguishable

from those of a

primary scirrhous

carcinoma of the

stomach.

Axial contrast-enhanced CT scan shows diffuse thickening of the stomach in this patient with gastric lymphoma.

Mucinous

adenocarcinoma of the

stomach. CT image

shows massive thickening

of the gastric wall and

marked luminal narrowing

by an advanced, infiltrating

carcinoma. Also note

extensive calcification

within the tumor. This type

of calcification is

characteristic of mucinous

adenocarcinomas of the

stomach.

CT demonstrates subtle nodularity and stranding of the mesentery and more apparent nodularity along the greater omentum (arrows) in a patient with ovarian cancer. A small amount of ascites (A) also can be seen.