Peritoneal metastases from gastric carcinoma

Case contributed by Dr Heba Abdelmonem

Presentation

Palpable hard abdominal mass.

Patient Data

Age: 30 years
Gender: Female

Diffuse infiltration of the omental fat by faintly enhancing soft tissue masses.

Moderate amount of ascites scalloping the hepatic surface.

Bilateral solid ovarian masses more evident on the left side raising the possibility of bilateral Krukenberg tumors.

Large cystic lesion lies just posterior to the lesser stomach curvature is mostly explained as a collection of malignant ascites passing from the greater sac to the lesser sac via the foramen of Winslow.

Axial CT images best demonstrate omental cake, hepatic surface scalloping as well as lesser sac collection.

Case Discussion

Female patient with history of gastric lesion proven to be gastric cancer underwent surgery 24 months ago, now presents with palpable hard abdominal mass with rapid increase of the abdominal size. CT of the abdomen and pelvis demonstrates malignant infiltration of the omental fat, malignant ascites (within the greater and lesser sacs) as well as bilateral ovarian solid masses, possibly Krukenberg tumors.

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