華山論劍-專業案例挑戰/Case 2015-002

Date: 27 Feb. posted by 陳啟仁/曾政豪/湯道謙/戴啟明/曾兆明/張吉仰/牟聯瑞醫師學術天地

61 year-old male without any significant past medical/surgical history presents with progressive abdomen fullness and poor appetite for one month. Patient also sustained a 3kg BW loss over this time period. Patient denied fever, chills, abdomen pain, vomiting, diarrhea, constipation, cough, or dysuria. Patient subsequently presented to our ER for help. PE was significant for abdomen distension, hypoactive bowel sounds, and shifting dullness. Lab showed no leukocytosis, anemia, azotemia, or impair liver functions (per figure). Under the impression of abdomen fullness R/O ascites, he was admitted to Gastroenterology Ward.

CXR

Left pleural effusion, mild

KUB

Mild bowel gas retension at RUQ area

Echo

Heterogenous mass 6.3 cm at pelvic area with moderate ascites

What’s your Diagnosis?

Ready for answers?  CLICK HERE