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There are multiple low attenuating lesions scalloping the liver margin, some of which are highly calcified, characteristic of pseudomyxoma peritonei. There is also moderate ascites. The patient had a multiples surgeries and has multiple other less significant findings on this abdominal CT.
The patient's predisposing pathology for pseudomyxoma peritonei is unkown. However, most of the time, pseudomyxoma peritonei are gelatinous metastases from mucinous adenocarcinoma of the appendix. Ovarian carcinoma must be included in the differential diagnosis to explain the pseudomyxoma peritonei - at least it used to be included. However, appendiceal adenocarcinoma are now thought to be the only cause of pseudomyxoma peritonei (PMP).
*Pseudomyxoma peritonei also presents with scalloping of the spleen's margin.