37-year-old male with history of stage I seminoma (92) status post left orchiectomy and XRT. Evaluate for recurrence. As per oacis, subcutaneous lesion in the back muscles was biopsy proven granular cell tumor. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Precarinal lymph node measuring 1.3 x 0.6 cm, (image 36, series 4) a second reference lymph node measures 0.9 x 1.4 cm, (image 48, series 4).CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Three well-defined hypervascular lesions are seen within the liver which are not identified on prior examinations. Segment two liver lesion measures 0.9 x 0.8 cm, (image 75, series 4). Segment eight liver lesion measures 1.4 by 1.2 cm, (image 82, series 4). Segment four A liver lesion measures 1.3 x 1.1 cm, (image 86, series 4). Dedicated liver protocol was not obtained.These lesions demonstrate an appearance of hemangioma however since these lesions are not seen on previous examinations other considerations must include hypervascular metastatic lesions which would be atypical for seminomatous dissemination. Further evaluation with MRI or PET CT may be considered as clinically indicated.SPLEEN: Single ill-defined hypodense lesion remains stable compared to previous examinations.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
1. Nonspecific mediastinal lymphadenopathy. 2. Multiple hypervascular hepatic lesions likely demonstrate an appearance of hemangioma however since these lesions are not seen on previous examinations other considerations must include hypervascular metastasis which would be atypical for seminomatous dissemination. Further evaluation with MRI or PET CT may be considered as clinically indicated.