Hepatitis C cirrhosis, cholangiocarcinoma with ascites consistent with atypical cells. Status post right hepatectomy October 8, 2014. Exploratory laparotomy, lysis of adhesions and radiofrequency ablation of the right hepatic lobe January 6, 2016. ABDOMEN:LIVER, BILIARY TRACT: There is decreased size of a fluid-filled cavity measuring 7.5 x 4.5 cm (series 41, image 27), consistent with prior partial right hepatectomy. At the site of prior enhancement along the right hepatectomy margin, there is persistent nodular enhancement, though decreased in size compared to prior, measuring 1.9 x 1.4 cm (series 12 2, image 296), previously 2.2 x 1.4 cm. Comparison is limited due to differences in technique and modality. There is a new area of T1 hyperintensity within the hepatic dome, presumably blood products related to recent ablation. SPLEEN: Subcentimeter T2 hyperintense nonenhancing splenic lesion, probable cyst, not visualized on prior, probably due to technique. Mild splenomegaly.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Soft tissue thickening along the anterior abdominal wall, possibly postsurgical. No suspicious osseous lesion. OTHER: Small right pleural effusion. Small volume ascites.
1.Interval radiofrequency ablation of segment 8, with decreased but persistent enhancing nodular tissue along the right partial hepatectomy margin, suspicious for residual tumor and follow-up recommended.2.Ventral abdominal soft tissue thickening, nonspecific and may be postsurgical. Small ascites and right pleural effusion.