Paraganglioma - liver and bone metastases

Case contributed by Henry Knipe
Diagnosis almost certain

Presentation

Watery diarrhea.

Patient Data

Age: 30 years
Gender: Female

Bowel loops are displaced inferiorly by an enlarged liver. No evidence of obstruction or pneumoperitoneum. No fecal loading. Multiple lytic lesions demonstrated through bony pelvis and proximal femurs. Upper abdominal surgical clips. 

Case Discussion

This case is an example of how bowel loop gas pattern displacement can reflect other intra-abdominal pathology. Bones are a check area on abdominal radiographs - multiple metastatic deposits are evident here. These findings have been confirmed on PET-CT (not shown). 

This patient has a known history of metastatic paraganglioma. 

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