This report describes the unusual echographic presentation of metastatic carcinoma of the liver.
CASE REPORT
A 65 year old white male was admitted to the hospital reporting anorexia, 15-pound weight loss and vague upper abdominal discomfort.
Physical examination revealed a mildly cachectic patient. The abdomen was markedly protuberant without clinical ascites. The liver was readily palpable, firm and smooth, with a span of 22 cm in the midclavicular line.
Laboratory data revealed modest elevation of alkaline phosphatase and transaminases with normal bilirubin. Stools were guiac positive, but the hemogram was normal. Upper gastrointestinal examination showed a large mass lesion within the stomach. An ultrasound examination was performed.
METHOD
A Picker Echoview with 2.25 MHz transducer was used to obtain a B mode gray scale study. Scans were obtained in the usual transverse and longitudinal manner with the patient supine utilizing mineral oil as the coupling agent. The examination revealed two large, complex masses within the liver. A sharp horizontal interface was identified as gravity dependent (Fig. 1).
Subsequent endoscopy revealed adenocarcinoma of the stomach and a liver biopsy of the