This ASG video tip is brought to you by an educational grant from Braintree, a part of Cibela Pharmaceuticals, makers of SUTAB. This is a 54-year-old woman who underwent a right hemicolectomy for an appendiceal carcinoma two years ago. She's presenting now with abdominal pain or CT shows thickening of the colon wall in several areas. And this is the distal transverse colon. You can see an irregular mass lesion here, and there were several other areas, including in the descending colon and a little bit distally that had areas that are similar to these. Now you can see that we're probing one of these areas with a biopsy forcep. The correct answer here is pseudomyxoma. Clearly these masses are not involving the mucosa. They're below the level of the mucosa. Just would be a possibility if they weren't multifocal. And of course, the clue is the history that the patient has a appendiceal carcinoma. It was a mucinous appendiceal carcinoma and now has presented with pseudomyxoma with implants and lipoma, of course, ruled out by the number of the lesions. And you can see that there's no cushion sign. They're firm to probing.

abdominal pain

colon wall thickening

pseudomyxoma

mucinous appendiceal carcinoma

biopsy forcep