Enlarging liver cysts and shoulder pain. ABDOMEN:LIVER, BILIARY TRACT: Hepatomegaly measuring 25 cm in craniocaudal dimension secondary to innumerable small cystic foci and large hepatic dome cystic lesions. The largest is a septated lesion in the mid liver measuring 14.1 x 10.3 x 16.7 cm. An adjacent predominantly right hepatic lobe lesion measures 10.5 x 7.2 cm. An adjacent left hepatic lobe lesion measures 8.5 x 7.6 cm and contains complex fluid. In the periphery of segment 3 there is a 4.2 x 4.0 cm cystic lesion. The remaining cystic lesions measure less than 2 cm. There is no internal or mural nodular postcontrast enhancement of these lesions.No intrahepatic biliary ductal dilatation.SPLEEN: Normal splenic size without a focal lesion.PANCREAS: No significant abnormality noted.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: No significant abnormality noted.
Hepatomegaly with regional mass effect secondary to several very large cystic lesions without suspicious internal or mural enhancement, likely giant hepatic cysts. Given their size cystadenoma cannot be excluded.