Presentation
Diffuse abdominal pain.
Patient Data
A mesenteric hyperenhancing lesion is seen in the umbilical region measuring about 3 x 3.3 cm in axial dimensions with internal coarse calcification and spiculated margins surrounded by fat stranding. The mass showed intense arterial enhancement and mild venous washout characteristics. The surrounding small bowel loops showed mural enhancement.
The liver is of average size, showing established cirrhotic changes with multiple enhancing metastatic lesions displaying washout in the venous phase.
Multiple mesenteric, retrocaval and porta hepatis lymph nodes.
Moderate amount of free intraperitoneal fluid collection with associated mesenteric congestion.
Manifestations of portal hypertension are seen as moderate splenomegaly averaging 16.3 cm in maximal span, dilated portosystemic collaterals are seen at the lower oesophagal, perisplenic and retroperitoneal regions.
Case Discussion
The CT features of mesenteric mass are characteristic of carcinoid tumor with desmoid reaction and hypervascular hepatic metastases. The mesenteric mass biopsy revealed carcinoid tumor.
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