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Omental cake

Omental cake refers to infiltration of the omental fat by material of soft-tissue density. The appearances refer to the contiguous omental mass simulating the top of a cake.

The most common cause is metastases from ovarian, gastric or colon cancer.

Tuberculous peritonitis may also give this appearance. Masses on the peritoneal surfaces may also be present. Malignant ascites may be present. Lymphoma can present as omental caking, diffuse peritoneal thickening, and ascites, the best clue is significant lymphadenopathy.

core biopsy may be helpful if the primary tumour is unknown.

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