CT preop demonstrates a right lower chest mass ? pleural/extrapleural.
CT abdo/pelvis to further characterise:
Soft tissue density material (~50 HU) distributed diffusely throughout the peritoneal cavity. It involves the right and left subphrenic spaces, extends under the spleen and liver, involves the left paracolic gutter and extends into the pelvis (large mass in the rectovesical pouch). It enters the porta hepatis extending along the posterior wall of the gallbladder and along the falciform ligament. There is scalloping of the liver and spleen. There is displacement of bowel loops. The soft tissue density extending up into the right hemithorax is again visualised. No evidence of bowel obstruction. Small left renal cyst (4 HU). The pancreas and adrenal glands are normal. No free intraperitoneal gas. Small right effusion. The lung bases are clear.
Diffuse low attenuation masses throughout the peritoneal cavity are consistent with extensive peritoneal metastasis. No obvious intra-abdominal primary tumour. US guided biopsy of the omental tumour is a better alternative to CT guided biopsy if required.