Presentation
Work up for right upper quadrant pain.
Patient Data
Increased wall thickness due to tumoral infiltration is present at the hepatic flexure of the colon, accompanied by pericolic fat stranding. There are signs of local invasion to the adjacent liver, and a 90 mm lobulated low-enhancing mass is present at hepatic 4th and 5th segments just beside the colonic mass. Additionally, increased wall thickness, suggestive of local tumoral infiltration, is evident at the gastric antrum and pylorus medial to the mentioned hepatic mass.
The gallbladder is contracted and contains several stones less than 25 mm. The gallbladder fundus shows a wall thickening in the vicinity of the hepatic mass.
Several enlarged lymph nodes are seen adjacent to the diseased segments with SAD less than 14 mm.
A few non-enhanced simple cortical cysts are seen at both kidneys.
Grade I spondylolisthesis of the L4 on L5 is evident.
Case Discussion
The patient underwent a tissue exam and histopathology, and immunohistochemistry evaluation confirmed colon adenocarcinoma as a primary source of the multi-organ tumoral infiltration.