Differential Diagnosis for a Lobular Mass Superior to the Bladder
Single Most Likely Diagnosis
- Ovarian Mass: Given the location superior to the bladder and the size of the mass (5.4 x 8.2 x 7.5 cm), an ovarian mass is a strong consideration. Ovarian masses can grow quite large and can displace adjacent structures such as bowel loops.
Other Likely Diagnoses
- Uterine Fibroid: Although typically associated with the uterus, large fibroids can extend beyond the uterine borders and displace adjacent structures. Their location and size could fit the description provided.
- Bladder Mass: A mass originating from the bladder itself could also present in this manner, especially if it is large enough to displace bowel loops.
- Colorectal Mass: A mass in the colon or rectum, particularly if it is located near the bladder, could cause displacement of bowel loops and present as a lobular mass in this area.
Do Not Miss Diagnoses
- Appendiceal Mass: Although less common, an appendiceal mass (due to appendicitis or an appendiceal tumor) could potentially present in this location if the appendix is retrocecal and the mass is large enough.
- Lymphoma: Involvement of lymph nodes in the pelvis could lead to a large mass that displaces bowel loops. Lymphoma is a critical diagnosis not to miss due to its significant implications for treatment and prognosis.
- Metastatic Disease: Metastases to the pelvis from a variety of primary cancers could also present as a large mass displacing bowel loops. This diagnosis is crucial to consider due to its impact on staging and treatment of the underlying cancer.
Rare Diagnoses
- Gastrointestinal Stromal Tumor (GIST): Although more commonly found in the stomach or small intestine, a GIST could theoretically occur in the pelvis and present as a large, lobular mass.
- Retroperitoneal Sarcoma: Sarcomas originating in the retroperitoneum are rare but could present as a large mass in the pelvis, displacing adjacent structures.
- Ectopic Pregnancy (in a rudimentary horn): In rare cases, an ectopic pregnancy can occur in a rudimentary uterine horn, which might present as a pelvic mass. However, this would typically be associated with symptoms of pregnancy and acute abdominal pain.