Wk 4, Case 2 - Review

PATIENT HISTORY: Epigastric pain

Study: CT abdomen pelvis with intravenous contrast.

TECHNIQUE: CT images of the abdomen and pelvis were obtained after the administration of intravenous contrast.

FINDINGS:

Lung bases: Few nonspecific sub-5 mm calcified noncalcified nodules are present at the lung bases.

Hepatobiliary: Unremarkable.

Pancreas: Unremarkable.

Spleen: Unremarkable.

Adrenal glands: Right adrenal gland is unremarkable. There is an indeterminate 1.2 cm left adrenal nodule.

Kidneys: Small left renal cyst is noted. Right kidney is unremarkable.

Bowel: There is a 4.5 cm exophytic mass arising posteriorly from the gastric fundus. No bowel obstruction.

Abdominal and pelvic lymph nodes: Few prominent subcentimeter retroperitoneal nodes are nonspecific.

Peritoneum: No ascites.

Vasculature: No abdominal aortic aneurysm. A few varicosities are noted draining to the left common femoral vein.

Pelvis: No mass.

Musculoskeletal system and soft tissue: No aggressive osseous lesion.

IMPRESSION:

1. Exophytic mass arising posteriorly from the gastric fundus. While nonspecific, gastrointestinal stromal tumor is favored. There are no findings of metastatic disease in the abdomen or pelvis.

2. Indeterminate left adrenal nodule. Comparison to prior studies, if available, suggested for further evaluation. If no prior studies are available for review, a CT or MRI study performed utilizing an adrenal mass protocol can be performed for characterization. A biochemical workup could be obtained if there are signs or symptoms of adrenal hyperfunction.