History of elevated LFTs and metastases from uveal melanoma. ABDOMEN:LIVER, BILIARY TRACT: There are numerous liver metastases compatible with melanoma metastases. The largest is a large mass in the right hepatic lobe measuring up to 9.8 x 10.4 cm (series 5/23). Additionally there is extensive porta hepatis soft tissue infiltration encasing the common bile duct.. The thin section MRCP images demonstrate a focal high-grade narrowing of the midportion of the common bile duct (series 9 image 3), which may be in part due to a crossing vessel. Proximally the common bile duct measures 3 to 4 mm. Additionally there is a focal complete narrowing of the right biliary tree with significant right hepatic lobe biliary ductal dilatation.The portal vein is patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Aortocaval and portacaval lymphadenopathy extending into the porta hepatis.BOWEL, MESENTERY: Soft tissue implants in the mesentery compatible with metastatic disease. A right mesenteric mass measures 3.1 x 2.5 cm (series 5 image 2).BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Left pleural effusion with extensive soft tissue pleural nodular thickening, left greater than right compatible with metastatic disease. Left hilar lymphadenopathy better characterized on recent CT.
1.Focal high-grade narrowing of the midportion of the common bile duct, which may be in part due to a crossing vessel, and focal complete narrowing of the right biliary tree with significant right hepatic lobe biliary ductal dilatation.2.Extensive hepatic metastases and tumor infiltration in the porta hepatis encasing the biliary system. Upper abdominal metastases including lymphadenopathy and mesenteric implants.3.Extensive metastatic disease to the chest.