RT Journal
A1 Chance L. I, Thomas C. N
T1 IMage of the month—quiz case
JF Archives of Surgery
JO Archives of Surgery
YR 2010
FD September 1
VO 145
IS 9
SP 911
OP 911
DO 10.1001/archsurg.2010.168-a
UL http://dx.doi.org/10.1001/archsurg.2010.168-a
AB 
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).