Omental cake from metastatic lung carcinoma

Case contribution: Dr Radhiana Hassan


  • A 62 years old lady
  • Newly diagnosed non-small cell lung carcinoma
  • CT scan is done for staging
Contrast-enhanced CT thorax and abdomen in axial planes soft tissue window

CT scan findings:

  • There is a mass within collapsed left lower lobe (red arrows).
  • There is associated left pleural effusion
  • Irregular pleural thickening is also seen on the left side
  • Soft tissue density within the anterior peritoneum (yellow arrows)
  • No ascites. No enlargement of paraortic or paracaval nodes.

Impression: Omental caking from metastatic lung carcinoma


  • Omental caking is a radiological sign which on CT scan identified as diffuse hazziness or mass like effect of omentum.
  • Omental spread of malignancy can cause localized or diffuse infiltration of omental fat by soft tissue density resulting in omental caking.
  • It is often indicates an advanced stage of diseases.
  • An omental cake is classically associated with ovarian carcinoma, but it may also be seen with carcinomatosis and lymphomatosis, mesothelioma, primary peritoneal serous carcinoma, tubal carcinoma, and rarely, cholangiocarcinoma
  • Hematogenous spread of malignant melanoma, breast and lung carcinoma are also common.
  • CT scan is a good diagnostic modality to assess omental pathologies.

Progress of patient:

  • Patient was diagnosed with stage 4 disease
  • He shows good response to chemotherapy

Author: radhianahassan