Peritoneal carcinomatosis

Case contributed by Dr Bruno Di Muzio


Patient diagnosed with adenocarcinoma of the colon (colonoscopy showing lesion in the distal transverse colon). Displays sudden onset of abdominal pain and distention.

Patient Data

Age: 71
Gender: Male

CT Abdomen and pelvis


Increased attenuation of mesenteric fat around the bowel, heterogeneous multi-nodular aspect with soft tissue attenuation. There is ascites and slight focal thickening of the transverse colon wall (poorly delimited due to the method used) that may correspond to a vegetative lesion of the colon (adenocarcinoma).

Case Discussion

Carcinomatosis implants tend to be flat or ovoid and conform to the adjacent structures; Bowel obstruction and hydronephrosis are frequently seen and also the presence of ascites (different from sarcomatosis1.

All peritoneal surface malignancies share similar radiologic features, with seeding of soft-tissue implants along the peritoneum and omentum, rendering differentiation of sarcomatosis from other peritoneal surface malignancies difficult solely by imaging 1.

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