Case contribution: Dr Radhiana Hassan
Clinical:
- A 62 years old lady
- Newly diagnosed non-small cell lung carcinoma
- CT scan is done for staging
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
Discussion:
- 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
