Fluoroscopy Procedures (Contrast Enema, Upper GI Series, Small-Bowel Follow-Through) Fluoroscopy studies, such as contrast enema, upper gastrointestinal (GI) series, and small-bowel follow-through (SBFT), are usually not first-line imaging studies for palpable masses in adults. However, they may be used to further characterize associated degree of obstruction or abnormalities in GI function or transit [28]. As extraluminal findings are commonly not evaluated by contrast enema or upper GI series, additional imaging may be required even if an intraluminal mass is detected. Palpable Abdominal Mass-Suspected Neoplasm FDG-PET/CT Skull Base to Mid-Thigh In the absence of a known diagnosis, there is a very limited role for fluorine-18-2-fluoro-2-deoxy-D-glucose (FDG)-PET/CT in patients with palpable abnormalities. There is no literature to support its use as an initial imaging modality. The main role of FDG-PET/CT would be to stage a known neoplasm, potentially presenting with a new palpable abnormality. Variant 2: Palpable abdominal mass. Suspected abdominal wall mass. Initial imaging. The annual incidence of benign soft-tissue masses is approximately 3,000 per million population [29]. The rate of malignancy ranges from 5% to 42% in large series [30,31]. Clinical evaluation and history are important for developing a differential diagnosis, with features of large size, location within the abdominal cavity, growth, and recurrence at an excision site in a patient with a history of malignancy all raising suspicion of malignancy [31]. Imaging often plays a central role in further narrowing the differential diagnosis and guiding management. However, similar to Variant 1, there are few recent studies, and the overall quality of the literature is poor and primarily focused on specific disease processes rather than a diagnostic approach to palpable masses [32-36].
Palpable Abdominal Mass Suspected Neoplasm. Fluoroscopy Procedures (Contrast Enema, Upper GI Series, Small-Bowel Follow-Through) Fluoroscopy studies, such as contrast enema, upper gastrointestinal (GI) series, and small-bowel follow-through (SBFT), are usually not first-line imaging studies for palpable masses in adults. However, they may be used to further characterize associated degree of obstruction or abnormalities in GI function or transit [28]. As extraluminal findings are commonly not evaluated by contrast enema or upper GI series, additional imaging may be required even if an intraluminal mass is detected. Palpable Abdominal Mass-Suspected Neoplasm FDG-PET/CT Skull Base to Mid-Thigh In the absence of a known diagnosis, there is a very limited role for fluorine-18-2-fluoro-2-deoxy-D-glucose (FDG)-PET/CT in patients with palpable abnormalities. There is no literature to support its use as an initial imaging modality. The main role of FDG-PET/CT would be to stage a known neoplasm, potentially presenting with a new palpable abnormality. Variant 2: Palpable abdominal mass. Suspected abdominal wall mass. Initial imaging. The annual incidence of benign soft-tissue masses is approximately 3,000 per million population [29]. The rate of malignancy ranges from 5% to 42% in large series [30,31]. Clinical evaluation and history are important for developing a differential diagnosis, with features of large size, location within the abdominal cavity, growth, and recurrence at an excision site in a patient with a history of malignancy all raising suspicion of malignancy [31]. Imaging often plays a central role in further narrowing the differential diagnosis and guiding management. However, similar to Variant 1, there are few recent studies, and the overall quality of the literature is poor and primarily focused on specific disease processes rather than a diagnostic approach to palpable masses [32-36].