Differential Diagnosis
- Single most likely diagnosis
- Metastatic cancer: The presence of multiple liver lesions, peritoneal deposits, and a lung nodule suggests a malignant process, with metastatic cancer being the most likely diagnosis. The primary site of the cancer is not specified, but the findings are consistent with disseminated disease.
- Other Likely diagnoses
- Hepatocellular carcinoma with metastases: Although less likely than metastatic cancer from an unknown primary, hepatocellular carcinoma could explain the liver lesions and peritoneal deposits.
- Lymphoma: Lymphoma could also present with multiple liver lesions, peritoneal involvement, and lung nodules, although it is less likely than metastatic cancer.
- Peritoneal carcinomatosis: This condition, characterized by the spread of cancer throughout the peritoneal cavity, could explain the peritoneal deposits and liver lesions.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pheochromocytoma: The small arterial enhancing lesion in the left adrenal gland could be a pheochromocytoma, which is a rare but potentially life-threatening condition if not diagnosed and treated promptly.
- Abdominal aortic aneurysm rupture: The fusiform abdominal aortic aneurysm is a significant finding that requires monitoring and potential intervention to prevent rupture, which would be catastrophic.
- Renal cell carcinoma: The left renal calculus and bilateral perinephric fat stranding could be related to a renal cell carcinoma, which would be a significant diagnosis to miss.
- Rare diagnoses
- Neuroendocrine tumor: The small arterial enhancing lesion in the left adrenal gland could be a neuroendocrine tumor, although this is less likely than other diagnoses.
- Sarcoma: The lung nodule and liver lesions could be related to a sarcoma, although this is a rare diagnosis.
- Tuberculosis: The peritoneal deposits and lung nodule could be related to tuberculosis, although this would be an unusual presentation in an immunocompetent host.