58-year-old male with large necrotic liver mass. Additional history from prior reports: History of esophageal squamous cell carcinoma status post neoadjuvant chemoradiation therapy and subtotal esophagectomy in 2003. Recently found to have 5 cm necrotic liver mass. Pathology report says "poorly differentiated adenocarcinoma. Findings are not consistent with metastasis from squamous primary. Instead, a primary intrahepatic cholangiocarcinoma or metastasis from a primary pancreaticobiliary adenocarcinoma is regarded as most likely." ABDOMEN:LIVER, BILIARY TRACT: A large well-defined segment 8 lesion measures approximately 4.1 x 4.3 cm and demonstrates delayed heterogeneous enhancement with lack of enhancement centrally suggesting central necrosis. There is no associated biliary ductal dilatation. The background liver is otherwise unremarkable with no other suspicious lesions. These findings are most suggestive of cholangiocarcinoma. No evidence of local nodal disease.SPLEEN: No significant abnormality noted.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.
Large 4.3 cm segment 8 hepatic lesion with findings favoring cholangiocarcinoma.No other hepatic lesions or evidence of nodal disease is identified.