81-year-old male with renal mass. Exam limitations are related to respiratory motion artifacts.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Small T1 hypointense and T2 hypointense focus of the upper splenic pole correlates with large calcified granuloma on the 2013 CT exam.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple cysts in the bilateral kidneys. There are multiple bilateral small T2 hyperintense foci that are too small to characterize.In the right kidney, a lower pole exophytic 1.1 cm T1 hyperintense and T2 hypointense lesion demonstrates no contrast enhancement and is favored to be benign. Other: The hyperintense lesions of the right kidney also demonstrate T2 hyperintensity and are felt related to proteinaceous cyst. No hydronephrosis.In the interpolar region of the left kidney, there is a 5 x 4.3 cm lobulated mass that is hypointense on T2, heterogenous on T1, demonstrates contrast enhancement and is concerning for a renal cell carcinoma. No renal vein invasion or left sided retroperitoneal lymphadenopathy is seen.The left kidney also demonstrates multiple T2 hyperintense simple cysts, and a few demonstrate T1 hyperintense signal compatible with proteinaceous material. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: In the anterior aortocaval region, there is a 1.3 x 1.6 cm soft tissue lesion that demonstrates T1 hypointense, T2 hyperintense (axial series 701 image 8), and post contrast enhancement (axial series 1/3/2003 image 68). This lesion is stable in size since the 2013 CT exam.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Large T2 hyperintense and enhancing lesion of the left kidney measuring 5 x 4.3 cm is consistent with a renal cell carcinoma. No renal vein invasion. No regional lymphadenopathy.2.An aortocaval soft tissue lesion measuring 1.3 x 1.6 cm is stable in size since the 1/7/2013 CT exam. Given the stability and imaging features described above a benign etiology such as an extra-adrenal pheochromocytoma or benign nerve sheath tumor is favored.