Male; 42 years old. Reason: VHL, s/p bilateral adrenalectomy for pheochromocytoma and history of paraganglioma. Abdomen:LIVER, BILIARY TRACT: Scattered subcentimeter cysts but no suspicious liver lesions. No biliary ductal dilatation. Hepatic vasculature patent. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Status post bilateral adrenalectomy. KIDNEYS, URETERS: Bilateral simple renal cysts. Subcentimeter T1 hyperintense and T2 hypointense lesion in the left lower pole is consistent with hemorrhagic cyst, unchanged (series 1001, image 58). RETROPERITONEUM, LYMPH NODES: No significant retroperitoneal adenopathy. Nonenhancing T2 hyperintense lesion in the left retroperitoneum measures 1.1 x 0.8 cm, previously 1.0 x 0.7 cm (series 601, image 27). T2 hyperintense, enhancing lesion in the midline about 2 cm inferior to the aortic bifurcation measures 1.2 x 1.0 cm, previously 1.2 x 0.9 cm (series 1601, image 98). Imaging findings are consistent with paraganglioma. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: T2 hyperintense enhancing extraaxial lesions are again noted along the nerve roots of the lumbar spine. The largest of these measures 1.4 x 1.3 cm at the level of L1, previously 1.0 x 0.9 cm (series 1104, image 289). OTHER: No significant abnormality noted.Pelvis:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: T2 hyperintense enhancing extraaxial lesions are again noted along the nerve roots of the lumbar spine. The largest of these measures 1.4 x 1.3 cm at the level of L1, previously 1.0 x 0.9 cm (series 1104, image 289). OTHER: No significant abnormality noted.
1.No significant interval change in paraganglioma just inferior to the aortic bifurcation and left retroperitoneal non-enhancing reference lesion. Please see measurements above. 2.Mild interval increase in size of largest extra-axial enhancing lesion at the level of the L1 nerve root, compatible with hemangioblastoma. Additional smaller hemangioblastomas are also again seen. 3.No new sites of disease identified in the abdomen/pelvis.