Tumor in the lesser sac.

Clinical case: A 46 year-old patient, with no significant past medical history or family medical history, complaining of mild epigastric discomfort and weight loss during the past year was examined by abdominal ultrasound. During the US examination a 11/9.5/6.5cm mass was identified anterior to the body and tail of the pancreas, and posterior to the stomach, in the area of the lesser sac (fig. 1). The 3D reconstruction of the tumor establishes its origin in the posterior gastric wall and reveals its internal structure (fig. 2): well-defined, with complex echostructure, heterogeneous, predominantly parenchymal, but also with a 3/3 cm fluid area (probably necrosis). The Doppler examination revealed peripheral and central vascularization. Relatively high maximum flow velocity (20-25 cm/s) and impedance indices (RI=0.8-0.9, PI=22.4) were recorded (fig. 3). The abdominal ultrasound also revealed mild splenomegaly and a small accessory spleen.