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There is a 7.5 x 6.2 x 6.7 cm hyperenhancing mass adjacent to the inferolateral wall of the second and third parts of the duodenum with patchy hypodense regions, likely representing areas of necrosis. A feeding vessel appears to arise from the inferior mesenteric artery. Multiple large (15 mm diameter ) serpiginous vessels extend from the inferior margin of the mass and appear to represent veins draining into the IVC, with commensurate elevation of density of blood in the IVC before and after the mass. No surrounding desmoplastic reaction.
Hypodensity in the liver adjacent to the ligamentum teres in keeping with focal fatty infiltration.
The gallbladder, spleen, pancreas, kidneys and adrenals are unremarkable. No lymphadenopathy by size criteria.
Soft tissue stranding over the abdomen in a seatbelt distribution without any large haematoma.
No free intraperitoneal gas or fluid. The lung bases are clear. No destructive osseous lesion.
Conclusion: 7.5 cm mass adjacent to the duodenum with large draining veins. The differential includes a sarcoma, and given the prominant vascular component perhaps and angiosarcoma, or GIST (D2/3 junction). No evidence of metastatic disease.