61-year-old male with history of renal cancer, concern for hepatic metastases. ABDOMEN:LIVER, BILIARY TRACT: There is no definite enhancing hepatic mass lesion identified. The large right renal mass causes extrinsic mass effect on the right hepatic lobe with adjacent heterogeneous enhancement in this region immediately adjacent to renal mass. The noncontrast coronal images suggest that the renal mass remains encapsulated and merely abutting liver but direct invasion cannot be excluded. There is a 1 cm flash filling hemangioma in segment II. There is no biliary ductal dilatation. The gallbladder appears normal.SPLEEN: No significant abnormality noted.PANCREAS: There is normal signal intensity in the pelvis. No focal pancreas lesion is identified. There is no pancreatic ductal dilatation.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: There is a large, heterogeneous, enhancing mass extending from the right upper pole kidney which measures 6.6 x 6.4 x 7.4 cm, compatible with known renal malignancy. There is enhancing thrombus in the proximal right renal vein, concerning for direct invasion (series 803, image 194). This does not extend to the inferior vena cava. Left kidney is normal.RETROPERITONEUM, LYMPH NODES: No thrombus is identified in the IVC. There is no significant retroperitoneal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No discrete osseous lesion is identified.OTHER: No significant abnormality noted.
1.No discrete intrahepatic mass is identified.2.Heterogeneous enhancement in the right hepatic lobe adjacent to extrinsic compression from large right renal mass --- favored to be compression effect alone, but direct invasion cannot be excluded.3.Large right renal mass with tumor thrombus in the right renal vein.