10-year-old female with a history of tubular sclerosis. ABDOMEN:Please note exam is limited by motion artifact and artifact from loss of signal anteriorly.LIVER, BILIARY TRACT: No focal hepatic mass. No intra or extra hepatic biliary ductal dilatation. The gallbladder is normal in appearance.SPLEEN: Heterogeneous foci scattered throughout the spleen may reflect splenic hamartomas. The largest focus measures 2.8 x 3.1 cm.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: The adrenal glands are not visualized.KIDNEYS, URETERS: Large heterogeneous mass occupying the majority of the upper and midpole of the right kidney. The mass measures 9.8 x 8.6 x 11.2 cm (series 901, image 22 and series 501, image 16). A large prominent blood vessel appears to be at the periphery of the mass and drains into the inferior vena cava. There is mass effect on the liver and multiple bowel loops.There is a slightly smaller mass occupying the inferior pole anteriorly with only a small amount of renal parenchyma remaining. The mass measures approximately 4.8 x 5.9 x 6.2 cm (series 901, image 34 and series 501, image 22). There is mass effect on the inferior vena cava at approximately the L4 level.Right-sided hydronephrosis. Innumerable bilateral T2 hyperintense foci compatible with renal cysts. Additional hypointense foci bilaterally compatible with angiomyolipomas. The largest of which on the left measures 2.9 x 2.2 cm (series 901, image 23). Note is made of a retroaortic left renal vein.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Bilateral dependent atelectasis in the partially visualized lung bases.
1. Large heterogeneous right renal masses exerting mass effect on the liver, bowel, inferior vena cava, and right renal collecting system likely angiomyolipomas. Smaller bilateral angiomyolipomas and innumerable renal cysts.2. Heterogeneous foci in the spleen are suggestive of splenic hamartomas.The above findings were communicated via telephone to Dr. Magno at 11:24 AM on 6/21/2016. The patient will be admitted to Comer Children's Hospital. 