Case 18-2005 - A 45-Year-Old Woman with a Painful Mass in the Abdomen

doi:10.1056/NEJMcpc059013

Volume 352:2535-2542		June 16, 2005		Number 24

Case 18-2005 — A 45-Year-Old Woman with a Painful Mass in the Abdomen

Michael G. Muto, M.D., Mary Jane O'Neill, M.D., and Esther Oliva, M.D.

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Presentation of Case

A 45-year-old woman was admitted to this hospital with a painfulabdominal mass.

She had first noticed a mass in her lower abdomen on the rightside two and a half years earlier. There was intermittent severepain at the site that occurred approximately once a month andlasted four to five days; it was worse during some months thanothers. She described the pain as feeling "like a hot brick."Five weeks before admission, she came to the surgical clinicof this hospital for further evaluation. A slightly tender mass,4 cm in diameter, was palpated in the right . . . [Full Text of this Article]

Differential Diagnosis

Hernias and Abscesses

Tumors

Endometriotic Implants

The Hepatic Lesion

Clinical Diagnosis

Dr. Michael G. Muto's Diagnosis

Pathological Discussion

Anatomical Diagnosis

Source Information

From the Division of Gynecologic Oncology, Gillette Center for Women's Cancers, Dana–Farber Cancer Institute and Brigham and Women's Hospital (M.G.M.); the Departments of Radiology (M.J.O.) and Pathology (E.O.), Massachusetts General Hospital; and the Departments of Obstetrics, Gynecology and Reproductive Biology (M.G.M.), Radiology (M.J.O.), and Pathology (E.O.), Harvard Medical School — all in Boston.