Transverse colon cancer with fistula to duodenum and gallbladder
Abdominal pain, weight loss and anaemia
CT abdomen and pelvis
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Large enhancing mass with irregular margins involving proximal transverse colon, with fistula to adjacent duodenum and gallbladder. Tracks with gas between mass and duodenum and gallbladder, with additional findings of gas in the gallbladder and intrahepatic biliary tree, confirm fistula.
Incidental findings of an atrophic left kidney with left renal artery ostial stenosis, and bilateral calcified pleural plaques.
Fistulation into another organ confers a T stage of T4 for this colonic adenocarcinoma.