Rubesin S E, Levine M S
Radiology. 1985 Mar;154(3):593-6. doi: 10.1148/radiology.154.3.3969458.
The authors describe 7 cases of pelvic malignancy (4 ovarian, 1 bladder, 1 cervical, and 1 endometrial) in which pathological examination demonstrated involvement of the transverse colon by contiguous spread from the greater omentum. Most patients had a pelvic mass at the time of presentation. All also had evidence of intraperitoneal seeding in the anterior rectosigmoid, the superior border of the sigmoid, or the medial border of the cecum, ascending colon, or ileum. Barium-enema examination showed predominant involvement of the superior border of the transverse colon with a mass effect, nodularity, and tethered mucosal folds, although focal or diffuse areas of circumferential narrowing were also identified. This appearance may be indistinguishable from direct extension of gastric carcinoma via the gastrocolic ligament; however, a pelvic mass or intraperitoneal colonic seeding should alert the radiologist to possible malignant spread from the greater omentum.
作者描述了7例盆腔恶性肿瘤（4例卵巢癌、1例膀胱癌、1例宫颈癌和1例子宫内膜癌），病理检查显示横结肠因大网膜的连续蔓延而受累。大多数患者就诊时盆腔有肿块。所有患者在直肠乙状结肠前部、乙状结肠上缘或盲肠、升结肠或回肠内侧缘均有腹膜种植的证据。钡灌肠检查显示横结肠上缘主要受累，有肿块效应、结节状及黏膜皱襞牵拉，尽管也发现了局限性或弥漫性的环形狭窄区域。这种表现可能与胃癌经胃结肠韧带直接蔓延难以区分；然而，盆腔肿块或腹膜内结肠种植应提醒放射科医生注意可能来自大网膜的恶性扩散。
