Diagnostic challenge: a 79-year-old woman with calcified lower abdomen mass.

Quiz A 79-year-old woman presented with fever, diarrhoea, vomiting and abdominal pain for several hours. Her temperature was 39.2°C, pulse 102 beats/minute, respiratory rate 19 breaths/minute, and blood pressure 149/74 mmHg. A physical examination revealed diffuse abdominal tenderness. Her white blood cell count was 5600/μL (band 20%, neutrophil 60%), blood urea nitrogen (BUN) was 48 mg/dL, creatinine 5.6 mg/dL, C-reactive protein 6.19 mg/ dL and glucose 177 mg/dL. Computed tomography (CT) scans without enhancement of the abdomen are shown in Figures 1, 2A and 2B.