Male 63 years old with pancreatic neuroendocrine tumor with liver mets, please evaluate for interval change. ABDOMEN:LIVER, BILIARY TRACT: Numerous hepatic lesions with peripheral arterial enhancement and diffusion restriction are again noted.The reference segment 5 lesion measures 2.2 x 1.9 cm (series 801, image 190), previously 2.1 x 1.8 cm.Reference segment 6 lesion measures 2.2 x 1.9 cm (image 108, image 134), unchanged.The remaining lesions are not significantly changed in size or number.No significant intra or extrahepatic biliary ductal dilatation. There is susceptibility artifact from the common bile duct stent and from pneumobilia in the left hepatic lobe. The hepatic vasculature appears patent.SPLEEN: No significant abnormality noted.PANCREAS: The reference ill-defined, enhancing pancreatic head lesion measures 1.9 x 1.9 cm (series 801, image 150), previously 1.9 x 1.8 cm. There is atrophy of the upstream pancreatic body and tail. No pancreatic ductal dilatation.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Distended, trabeculated urinary bladder raises suspicion for bladder outlet obstruction.
1.Stable exam with unchanged size and number of arterial enhancing liver metastases.2.No significant change in the size of the enhancing pancreatic head lesion.3.No new sites of disease.