51-year-old male patient with history of kidney cancer with multiple renal lesions on prior imaging. ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: There are multiple lesions within both kidneys that do not meet criteria for simple cysts demonstrating low T1 signal, low T2 signal, and restriction diffusion which are most compatible with multifocal renal cell carcinoma. Some lesions are subcentimeter in size and too small to characterize. Each kidney is as described below.Right Kidney: There are at least 14 lesions within the right kidney which are suspicious for renal cell carcinoma, many of which appear larger in size compared to the prior study. There has been increase in size of a dominant right posterior interpolar region kidney lesion, which demonstrates regions of T2 hyperintensity, and now measures approximately 2.7 cm in diameter, previously 1.8 cm. Left Kidney:There are at least 12 lesions within the left kidney which are suspicious for renal cell carcinoma, many of which appear larger in size compared to the prior study. The dominant lesion in the left posterior interpolar region has increased in size measuring 1.5 cm, previously 1.1 cm (image 128, series 16). RETROPERITONEUM, LYMPH NODES: There is aneurysmal dilatation of the distal abdominal aorta near the bifurcation measuring 4.3 cm in the transverse dimension. There is circumferential mural thrombus within the aortic aneurysm. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Interval growth of multiple bilateral renal lesions which are most compatible with multifocal renal cell carcinoma. 