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OpenAthens Shibboleth
Special Feature
January 1, 2007

Image of the Month—Quiz Case

Author Affiliations

Author Affiliations:Department of Hepatobiliary Surgery, North Hampshire Hospital, Basingstoke, England.




Copyright 2007 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2007

Arch Surg. 2007;142(1):95. doi:10.1001/archsurg.142.1.95

A 78-year-old woman presented with palpitations and was diagnosed as having fast atrial fibrillation. On routine abdominal examination, a firm, mobile, nontender mass in the central abdomen was palpated. Abdominal computed tomography demonstrated a 10-cm-diameter, well-circumscribed lesion that was part solid and part cystic. It displaced small bowel loops and appeared to be intimately related to the inferior falciform ligament (Figure 1). Based on these findings, the patient underwent laparotomy via an upper midline incision. The mass (Figure 2) was identified and appeared to be attached to the inferior border of the liver. No other intra-abdominal abnormality was found and the mass was excised in toto. The patient made an uneventful recovery and was discharged home 4 days after surgery.

Figure 1.
Image not available

Axial computed tomographic image of the abdomen.

Figure 2.
Image not available

Mass identified at midline laparotomy. The arrow points to the inferior border of the liver.

What Is the Diagnosis?

A. Sarcoma of the falciform ligament

B. Pedunculated hepatocellular carcinoma

C. Mesenteric gastrointestinal stromal tumor

D. Omental dermoid cyst