History of liver mass on outside CT, possible hemangioma. Also history of rectal cancer 15 cm from anal verge, evaluate whether rectal mass above or below the peritoneal reflection. Per electronic medical record, also history of obstructive uropathy (as reported on 8/28/16 clinic note). ABDOMEN:LIVER, BILIARY TRACT: There is a T2 hyperintense lesion within hepatic segment 5 measuring 3.9 x 3.1 cm which demonstrates peripheral nodular enhancement and progressive centripetal and likely represents a benign hemangioma. There are several additional scattered subcentimeter T2 hyperintense lesions, some of which demonstrate trace peripheral enhancement (for example segment 7, series 27 image 270) which are nonspecific but suspicious for metastases.The hepatic vasculature appears patent. The gallbladder is nondilated. No biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral mild-moderate hydroureteronephrosis. Mild perinephric stranding. A few subcentimeter renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: The prostate is mildly enlarged measuring 5.4 x 3.8 x 3.4 cm.BLADDER: Markedly distended. The bilateral ureterovesical junctions appear patent. No definite bladder wall masses are identified.LYMPH NODES: Lymph nodes in the perirectal space, within the mesorectal fascia: Several lymph nodes are present within the mesorectal fascia. The largest is on the left and measures 1.3 x 1.6 cm (series 14, image 11).Lymph nodes outside the mesorectal fascia: No abnormally enlarged lymph nodes identified.BOWEL, MESENTERY: Rectal Tumor:Size: 3.3 x 3.2 x 5.8 cm (image 20/series 14; image 30, series 15)Tumor appearance on T2-weighted images: Predominantly solid lesion with intermediate signal intensityTumor location: Approximately 12 cm from the lower edge of the tumor to the anal verge and centered at the junction of the peritoneal reflection with Denonvilliers fascia.Circumference of the rectum involved: 360 degrees. Relationship and proximity of the tumor to adjacent structures (prostate, seminal vesicles): The tumor appears to abut the posterior wall the bladder.MRI T-stage: T3c - Tumor invades >1cm into perirectal fat or extramuralTumor Distance to Mesorectal Fascia: The tumor on the right is within 1.4 cm the mesorectal fascia. On the left, an enlarged perirectal lymph node is within 1.0 cm the mesorectal fascia.BONES, SOFT TISSUES: Degenerative changes affect the hip joints. OTHER: No significant abnormality noted.
1.Rectal cancer with circumferential wall involvement and greater than 1 cm invasion into the perirectal fat which abuts the posterior bladder.2.Mild-moderate hydroureteronephrosis and markedly enlarged bladder suggesting bladder outlet obstruction. No definite bladder lesion are identified on this nondedicated exam. 3.Hepatic segment 5 lesion compatible with a benign hemangioma. 4.Several additional subcentimeter hepatic lesions which are nonspecific but suspicious for metastases.