Abstract
Case PresentationA 34-year-old woman presented to the emergency department with bilateral lower extremity edema and shortness of breath. She had been seen by her primary care provider. Lab work and a follow-up with endocrinology had been unrevealing. Using point-of-care ultrasound we identified a cystic mass in the right upper quadrant prompting further imaging.DiscussionAbdominal and pelvic computed tomography confirmed a mass in the right posterior liver, which was later identified as an adrenocortical carcinoma. Ultrasound is an important diagnostic tool in the setting of lower extremity edema and can be used to assess for heart failure, liver failure, obstructive nephropathy, venous thrombosis, and soft tissue infection. In this case, ultrasound helped expedite the diagnosis and treatment of a rare malignancy.
Highlights
Using point-of-care ultrasound we identified a cystic mass in the right upper quadrant prompting further imaging
Abdominal and pelvic computed tomography confirmed a mass in the right posterior liver, which was later identified as an adrenocortical carcinoma
This prompted computed tomography (CT) of the abdomen and pelvis, which confirmed a 7.9 x 9.1 x 8.7 centimeter mass arising from the right posterior liver, extending into the inferior vena cava with an associated near-occlusive tumor thrombus (Image 3)
Summary
Ohio State University College of Medicine, Department of Emergency Medicine, Columbus, Ohio. Case Presentation: A 34-year-old woman presented to the emergency department with bilateral lower extremity edema and shortness of breath. She had been seen by her primary care provider. Lab work and a follow-up with endocrinology had been unrevealing. Using point-of-care ultrasound we identified a cystic mass in the right upper quadrant prompting further imaging
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