Case of the month:

A 75 year old man presents with a 2 month history of abdominal distension and lethargy. Clinical examination demonstrates shifting dullness and investigations reveal he has a microcytic anaemia with raised tumour markers (CA19-9-208 U/ml , CEA-88 µg/L)  Ascitic aspiration yields a gelatinous fluid, the coronal section of his abdominal CT scan is shown above. What is the diagnosis (hint:the arrows point to the primary pathology)

Submitted by N. Patodi