A 60-year-old woman presents with abdominal pain, and a CT scan reveals an omental mass. The most likely diagnosis is:
Primary tumors of the omentum are rare, as is omental infarction. Metastatic tumors of the omentum are common, with metastatic ovarian carcinoma having the highest preponderance of omental involvement. Cancers of any portion of the gastrointestinal tract, as well as melanoma, uterine, and renal cancer, can metastasize to the omentum.
Failure of fixation of the small intestinal and right colonic mesentery during gestation can result in:
During fetal development, after the midgut rotates and returns to the abdominal cavity, the mesentery of the duodenum, small intestine, and proximal colon become fixed to the retroperitoneum. Failure of fixation results in a spectrum of disorders associated with intestinal malrotation.
Which of the following statements about sclerosing mesenteritis is FALSE?
The etiology of sclerosing mesenteritis is unknown but its cardinal feature is increased tissue density within the mesentery. This can be associated with a discreet non-neoplastic mass or it can be more diffuse involving large swaths of thickened mesentery without well-defined borders. Many cases are discovered incidentally on CT scans performed for unrelated reasons. The process is self-limited and may demonstrate regression on follow-up imaging studies.
The primary treatment of retroperitoneal fibrosis is:
Once malignancy, drug-induced disease, and infectious etiologies are ruled out, corticosteroids are the mainstay of medical therapy. Surgical intervention is reserved for ureterolysis or ureteral stenting, or endovascular interventions for ileocaval obstruction.
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