81-year-old male with history of RCC and liver metastases. ABDOMEN:LIVER, BILIARY TRACT: Multiple enhancing liver metastases again noted, significantly increased compared to the prior MRI, however stable compared to the prior CT.Right hepatic dome lesion measures 5.6 x 4.2 cm, previously 1.4 x 1.1 cm (image 13 of series 10).Segment 2 lesion measures 4.5 x 3.7 cm, appears a 2.3 x 1.5 cm (image 22 of series 10).Peripheral segment 6 lesion measures 3.5 x 3.9 cm, previously 3.5 x 2.1 cm (image 40 of series 10).Cholelithiasis. Segment 5 presumed hemangioma unchanged.SPLEEN: No significant abnormality noted.PANCREAS: Nonenhancing cystic lesion at the pancreatic head measures 1.3 x 1.0 cm, previously 1.4 x 0.8 cm (image 22 series 4).ADRENAL GLANDS: Status post right adrenalectomy.KIDNEYS, URETERS: Postoperative changes of right nephrectomy. Complex cystic lesion with dense calcification (correlated with prior CT imaging) in the left upper pole is unchanged. Other simple cystic lesions are unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Scoliosis.OTHER: No significant abnormality noted.
1. Significant progression of hepatic metastatic disease with reference measurements as above.2. Stable presumed simple pancreatic cystic lesion most likely representing a sidebranch IPMN.