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Special Feature
September 2010

Image of the Month—Quiz Case

Author Affiliations

Author Affiliations: Division of Vascular Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.

 

CARL E.BREDENBERGMD

Arch Surg. 2010;145(9):911. doi:10.1001/archsurg.2010.168-a

A 78-year-old man presented with fevers, cough, weakness, and diarrhea for 3 days. He had a recent hospitalization for pneumonia and acute-on-chronic renal insufficiency thought to be related to obstruction. Physical examination revealed a mildly distended abdomen with a large, nonpulsatile lower abdominal mass extending to the level of the umbilicus. Laboratory testing revealed a slight elevation in the serum creatinine level but was otherwise unremarkable. A computed tomographic scan of the abdomen and pelvis revealed a large pelvic mass with a few metallic densities about the periphery (Figure 1).

Figure 1.
Computed tomographic scan of the pelvis shows a large, homogeneous mass with a metallic density at the periphery.

Computed tomographic scan of the pelvis shows a large, homogeneous mass with a metallic density at the periphery.

What Is the Diagnosis?

A.  Iliac vein leiomyoma

B.  Pelvic sarcoma

C.  Internal iliac artery aneurysm

D.  Distended bladder

Answer

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