Adenocarcinoma of the gallbladder with extension into liver and hepatic flexure. Nodules on internal surface of bowel.
Did malignancy extend to hepatic flexure (microscopic description) or metastasize to hepatic flexure (final diagnosis)? Report as direct extension of tumor. "Direct extension of tumor" agrees with the microscopic description and is supported by the note on the diagram of the abdomen which says that the right colon was matted into the liver. (The distinction between direct extension and metastasis, non-contiguous disease, will be discussed in a later instructional manual.)