History of metastatic adenocarcinoma of uncertain primary. Restaging exam. ABDOMEN:LIVER, BILIARY TRACT: Liver is normal in signal and morphology. Subcentimeter focus of increased T2 signal in the right lobe likely a benign cyst. No intrahepatic or extrahepatic biliary ductal dilatation.SPLEEN: The spleen is upper limit of normal in size.PANCREAS: Subcentimeter T2 bright focus in the pancreatic body may reflect a small sidebranch IPMN. Main pancreatic duct is nondilated.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Status post transverse colectomy with right lower quadrant diverting colostomy and left lower quadrant mucocutaneous fistula. No obstruction. Redemonstration of rectal wall thickening and enhancement with perirectal and presacral edema.BONES, SOFT TISSUES: Heterogeneous marrow signal in the pelvis and proximal femurs felt to reflect recurrent red marrow.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy and bilateral salpingo-oophorectomy.BLADDER: No significant abnormality noted.BOWEL, MESENTERY: Redemonstrated rectal wall thickening and enhancement with perirectal and presacral edema. The edema extends to and involves multiple tethered loops of adjacent small bowel. This is stable to questionably increased when compared to prior.BONES, SOFT TISSUES: Diffusely heterogeneous signal likely reflecting red marrow reconstitution.OTHER: Right lung basilar nodule (series 6 image 6) is not significantly changed from prior, accounting for differences in imaging technique.
1.No specific evidence of recurrent or metastatic disease.2.Findings compatible with colitis/proctitis as described above. This appears similar to perhaps slightly increased when compared to prior. If the patient has a history of radiation to the pelvis, this may reflect posttreatment changes.