History of RCC and metastases. History of horseshoe kidney status post partial resection of the right moiety and left nephrectomy. Status post left distal pancreatectomy. Local recurrence and vascular invasion. ABDOMEN:LIVER, BILIARY TRACT: Stable segment 7 flash-filling hemangioma and small subcentimeter cysts. No suspicious liver lesion, biliary ductal dilatation or vascular abnormality.SPLEEN: No significant abnormality noted.PANCREAS: Status post partial distal pancreatectomy.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: The patient has a history of horseshoe kidney status post partial resection of the right moiety and total resection of the left moiety. The previously described lesion arising from the mid/inferior pole of the right moiety demonstrates mild interval decrease in size now measuring 4.8 x 2.6 cm (series 602/297) and marked decrease in central enhancement with only residual peripheral enhancement compatible with treatment response necrosis. This extends into the right renal vein and IVC, unchanged.Simple appearing cystic structure inferior to the lesion is unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Stable appearance of the third portion of the duodenum.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Interval mild decrease in size of the residual/recurrent tumor involving the mid/inferior portion of the right renal moiety with marked interval decrease in central enhancement compatible with treatment response necrosis. No evidence of metastatic disease.