Presentation
Epigastric pain. Gastric endoscopy revealed neoplastic masses in the gastric cardia and body.
Patient Data
FDG avid gastric circumferential nonuniform mural thickening of the gastric cardia and body encroaching upon its lumen with SUV max 7.4. No exophytic masses.
Increased FDG uptake by diffuse nodular mental soft tissue infiltration with SUV max 4.3 (omental cake).
Increased FDG uptake by enlarged regional left gastric and mesenteric lymph nodes.
Low grade FDG uptake by mild pelvic ascites.
Case Discussion
The case presents a typical appearance of omental cake metastatic from gastric cancer.
Omental cake refers to the infiltration of the omental fat by a 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.