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A 70 year old woman presented with a painless abdominal mass. She had a background of previous oesophageal carcinoma with liver metastases with a remarkably long disease free interval of over three years after complete response to local radiotherapy and systemic chemotherapy. Cholecystectomy had been performed for cholelithiasis more than 10 years previously.
Computed tomographic (CT) scan demonstrated a large cystic structure arising from the bowel mesentery (fig 1). A presumed diagnosis of recurrent disease was made. In the absence of other evidence of metastatic disease on CT of the chest, abdomen, and pelvis, surgical resection was planned.
What did laparotomy reveal as the cause of the abdominal mass?
See page 514 for answer
This case is submitted by:
Robin Spiller, editor
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