History of Merkel cell carcinoma. Mass in the right lateral chest wall. History of flap reconstruction (forehead). LUNGS AND PLEURA: No significant abnormality noted. MRI suboptimal to evaluate for lung lesions.MEDIASTINUM AND HILA: Tortuous thoracic aorta. Normal cardiac size without pericardial effusion.CHEST WALL: Mild dextroscoliosis and kyphosis. Degenerative disc disease of the lower cervical spine.Along the lower right lateral chest wall is a lenticular-shaped lesion demonstrating intrinsic T1-weighted hyperintensity (series 19/55) and T2-weighted hyperintensity (series 18/27). The central hyperintensity measures approximately 3.6 x 0.8 x 5.6 cm (series 18/27). There is moderate surrounding soft tissue enhancement. Overall the lesion appears slightly decreased from the prior study. Assessment for osseous involvement is more reliable on the recent prior CT. There is an adjacent prominent lymph node, likely reactive and unchanged. More superiorly, there is edema that extends near the axilla.UPPER ABDOMEN: Limited sequences through the upper abdomen show no discrete abnormality.
The complex lesion involving the right lateral chest wall demonstrates interval mild decrease in size with imaging characteristics favoring a resolving hematoma or treated infection. Although treated metastatic disease is a possibility, this is considered unlikely. Correlation with surgical and clinical history is recommended. If there is continued concern for metastatic disease follow-up CT of the chest can more reliably monitor the lesion. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.