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Sigmoid colon primary with liver and lung metastases

Case contributed by Varun Babu
Diagnosis almost certain


Right lumbar and iliac fossa pain. Referred by urologist for plain CT KUB

Patient Data

Age: 40 years
Gender: Male
  • ironically no stone or obstructive uropathy was found in this patient
  • there was enough evidence in the plain study to suggest presence of a locally infiltrative mass lesion in sigmoid colon and multiple focal liver lesions
  • the contrast enhanced study identified the numerous hypodense liver lesions, one of them largest in the right lobe
  • non circumferential long segment polypoidal mural thickening with transmural spread and second loop involvement is seen in the sigmoid mesocolon with regional lymph nodal involvement
  • focal round lesion seen in left lung  
  • curved planar reformation along the long axis of the serpiginous bowel enables us to have a clear cut view of extent and site of involvement of large bowel
  • images reconstructed using Syngo via of Siemens

Case Discussion

Unusual case presentation with just right iliac fossa pain. No symptoms of bowel obstruction or melena was present.  Prognosis is grave in stage IV disease with 10% survival.   

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