Fig. 9

Metastatic retroperitoneal involvement in an 80-year-old female, who presented with symptoms of bowel obstruction. She had declined surgical treatment for Stage 2B ILC a year earlier and was on letrozole. a Axial contrast-enhanced CT image shows a stricture of the descending colon, with a tethered, tapered appearance at its medial aspect (white arrow). The upstream transverse colon (*) is dilated. Left-sided hydronephrosis is also seen (black arrowhead). b Coronal contrast-enhanced CT image shows tiny metastatic nodules and stranding in the left side of the retroperitoneum (white arrow). The transition points of the left hydronephrosis (white arrowhead) and descending colon (not pictured) are within this nodular area. c Colonoscopy confirms a stricture of the descending colon (white arrow). The mucosa appeared normal on colonoscopy, and this was initially thought to represent a benign stricture. Subsequent open laparotomy confirmed disseminated metastatic disease in the retroperitoneum