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Special Feature
Dec 2011

Image of the Month—Quiz Case

Author Affiliations


Author Affiliations: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Arch Surg. 2011;146(12):1447. doi:10.1001/archsurg.146.12.1447

A 56-year-old African American man with no significant medical history was admitted to the hospital for evaluation of chest pain. During his workup, computed tomography of the chest, abdomen, and pelvis was performed, revealing a well-circumscribed, 3.2 × 3.1-cm mass located in the left pelvis, pressing on the urinary bladder (Figure 1). This mass appeared to contain a central focus of calcification and was not associated with any surrounding enlarged lymph nodes or inflammatory changes. No other abnormal findings were found on computed tomography, and his laboratory values were all within normal limits, including cardiac enzymes. The patient denied any history of abdominal pain, change in bowel habits, weight loss, melena, or urinary symptoms. His abdominal examination did not reveal any tenderness or guarding, and there was no palpable abdominal mass. Finally, a thorough diagnostic evaluation of the chest pain, which spontaneously resolved, failed to reveal any evidence of cardiopulmonary disease.