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Fig. 3D —77-year-old woman with mucinous appendiceal neoplasm. Coronal
gadolinium-enhanced gradient-echo image shows confluent upper and large middle
abdominal mesenteric mass (long arrows). Right subphrenic tumor
(short arrow) is also noted. Note that degree of tumor enhancement is
less than that of liver parenchyma. Both observers recorded level 2
enhancement (less than liver parenchyma), which indicates disseminated
peritoneal adenomucinosis or intermediate-type tumor. Extensive mesenteric
tumor predicts incomplete surgical resection. At surgery, bulky diffuse
abdominal tumor was found encasing transverse colon, mesentery, and small
bowel. Cytoreduction was incomplete.