60-year-old male with duodenal mass and liver lesions. ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis. The gallbladder is distended measuring 5 cm in short axis. There is no pericholecystic fluid or gallbladder wall thickening. There is moderate intrahepatic biliary ductal dilatation. The common bile duct measures 11 mm at the level of the pancreas. There is no choledocholithiasis.Multiple hypoenhancing subcentimeter foci and masses are noted throughout the liver most apparent on restricted diffusion, suspicious for metastatic disease. For reference, there is a segment 5/6 lesion measuring 13 x 11 mm (series 13, image 154).SPLEEN: No significant abnormality noted.PANCREAS: The main pancreatic duct is prominent measuring 5 mm.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: T2 hyperintense cysts in the inferior pole of the right kidney.RETROPERITONEUM, LYMPH NODES: Mildly enlarged periportal, gastrohepatic ligament, and gastroesophageal junction lymph nodes are present. For reference, there is a gastroesophageal junction lymph node measuring 1.6 cm in short axis.BOWEL, MESENTERY: There is an enhancing mass in segment 2/3 of the duodenum measuring 3.8 x 3.3 cm, with mass effect on the ampulla of Vater. Small bowel caliber is within normal limits without evidence of obstruction. The appendix is well visualized and within normal limits.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Duodenal mass with mass effect on ampulla resulting moderate intra- and extra-hepatic biliary ductal dilatation as well as pancreatic ductal dilatation.2.Numerous foci and masses throughout the liver suspicious for metastatic disease.