PEIR Digital Library

Welcome to the Pathology Education Informational Resource (PEIR) Digital Library, a multidisciplinary public access image database for use in medical education.

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RADIOLOGY: GASTROINTESTINAL: GI: Case# 33561: METASTATIC LIEOMYOSARCOMA SMALL BOWEL; MASSIVE METASTATIC DISEASE IN THE LIVER,. 34 year old female has severe nausea and vomiting, examination is requested to rule out perforation. Exam 1 1. Diffuse metastatic liver disease and suspected local small bowel recurrence of leiomyosarcoma. 2. Large ascites, but no contrast extravasation or pneumoperitoneum is identified. 3. Dilatation of the gallbladder and common duct to the level of the pancreas, but the pancreas is difficult to evaluate due to the mass effect of the enlarged liver. Exam 2 1. Massive metastatic disease in the liver, greatly increased since previous exam. 2. High density within the largest mass consistent with hemorrhage into the necrotic center. 3. Ascites with possible intraperitoneal hemorrhage. 4. Mild intrahepatic biliary dilatation. 5. Right basilar atelectasis with pleural effusion, probably secondary to compression from elevated right hemidiaphragm.

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Peter Anderson
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