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JAMA Surgery Clinical Challenge

A Well-Circumscribed, Painless Abdominal Mass

Image of Figure 1

Figure. Scout (A) and cross-sectional (B) images from a computed tomographic scan of the abdomen. A large, well-circumscribed mass (white arrow) is shown on the cross-sectional image.

Brian A. Boone, MD
Giselle G. Hamad, MD

A 28-year-old woman presented with a complaint of a painless abdominal mass that had been increasing in size during the past few years. Several different physicians had evaluated the patient previously without a definitive diagnosis or treatment. Her only significant medical history was a routine cesarean section 4 years earlier. Physical examination findings revealed a firm, mobile, nontender, midline abdominal mass. A computed tomographic scan was performed, which showed a well-circumscribed, 10-cm mass (Figure). The patient was scheduled for elective exploratory laparotomy and resection.

See the full article for an explanation and discussion.

Author Affiliations: Boone and Hamad (hamadg@upmc.edu) are affiliated with the Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.