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A CT scanning approach to the evaluation of left paraaortic pseudotumors.

Normal structures and organs were observed during clinical computed tomography as potential sources of false-positive tumor diagnosis. The left paraaortic region was a common location of pseudotumor masses that were frequently found to be of vascular or intestinal origin. Cases presented demonstrate that an appropriate use of conventional contrast medium can differentiate a normal anatomic structure simulating a mass from a pathologic process.

Abdominal Neoplasms↗

An unusual case of occlusive thromboaortopathy (Takayasu's disease)--a case report.

A case of Takayasu's disease presenting in a young man as a solid abdominal mass is described. The literature is reviewed and classifications of the disease are discussed. Occlusive thromboaortopathy, also known as "pulseless disease" or Takayasu's disease, was first described in 1908 by Takayasu, who observed cataracts and peculiar arteriovenous anastamoses around the optic papillae in a young woman. It is a vasculitic disorder of uncertain etiology occurring mainly in young women and may involve part or most of the aorta, as well as the pulmonary artery. Early features include fever, malaise, weight loss, and a high ESR, and, later on, absent pulses, aneurysms, hypertension, and heart failure may occur. The authors describe an unusual case of Takayasu's disease in a young black South African man.

Abdominal Neoplasms↗

Failure to visualise the abdominal portion of the inferior vena cava with computed tomography: a clue to underlying abdominal pathology.

Failure to visualise the intra-abdominal portion of the inferior vena cava (IVC) using contrast-enhanced computed tomography (CT) is unusual. A review of 1272 contrast-enhanced abdominal CT examinations revealed that the IVC was not visible at one or more levels in only 132 (10.4%). In 57 (43%), non-visualisation was due to pathological processes, most frequently metastatic carcinoma, causing compression or thrombosis of the IVC. In the remainder, technical factors or artefacts could explain the non-visualisation. Techniques and procedures to improve visualisation of the IVC are discussed. Failure to visualise the IVC on CT at any level unexplained by artefacts is abnormal.

Abdomen↗

[Benign symmetrical lipomatosis].

A man aged 51 for the last 3 months had displayed general malaise, epigastric pain, nausea, vomiting and constipation. Also, he had a pseudo-athletic appearance with symmetrical large accumulations of fat on the front of the trunk, the lower back, the shoulders and the proximal extremities, characteristic of 'benign symmetrical lipomatosis'. He died of embolism of the aortic bifurcation and autopsy revealed an extensive adenocarcinoma in the upper abdomen, probably originating from the pancreas or the stomach. Benign symmetrical lipomatosis mostly occurs in middle-aged men. The pathogenesis is unknown. Association with alcohol abuse, metabolic abnormalities, polyneuropathy and certain malignancies has been described. Treatment is symptomatic by surgery or liposuction.

Abdominal Neoplasms↗

Extra-adrenal pheochromocytoma (paraganglioma).

The authors describe the case of a 19-year-old female patient with an abdominal paraaortic extra-adrenal pheochromocytoma (paraganglioma), presenting arterial hypertension. The predominant catecholamine produced by the tumor was norepinephrine (4110 pg/ml; normal < 450 pg/ml). 131I metaiodobenzylguanidine (131I-MIBG), computed tomography and magnetic resonance imaging allowed location and characterization of the tumor. Histologically the tumor (weight = 34.2 g; 5.8 x 4 x 3 cm) was a typical pheochromocytoma.

Abdominal Neoplasms↗

Ectopic supernumerary kidney, a cause of para-aortic mass: case report and review.

Ectopic supernumerary kidney is a rare congenital urinary tract abnormality. Because of the scarcity of published cases and atypical presenting symptomatology this entity frequently causes a diagnostic as well as therapeutic dilemma. We report a case of an unusually symptomatic supernumerary kidney that presented as back pain. Noncontrast CT scan showed a suspicious left-sided para-aortic mass, which prompted a percutaneous biopsy. Intravenous contrast CT scan revealed an anatomically and functionally free supernumerary kidney. The approach to diagnosis as well as management of supernumerary kidneys is discussed herein.

Abdominal Neoplasms↗