Female 46 years old Reason: 46 y/o F with SCC of the anus w/ liver mets here with worsening RUQ pain. Please assess for worsening met disease. Please focus on the liver. History: pain ABDOMEN:LIVER, BILIARY TRACT: Multiple liver lesions are again identified.A hypoenhancing lesion consistent with an ablation defect is noted within segment 7 measures 4.9 x 1.1 cm (series 801, image 323) and is unchanged compared to prior study. A hypoenhancing lesion at the hepatic dome, posterolateral to the IVC measures 1.2 x 0.9 cm (series 801, image 368). This is stable in size compared to prior CT 05/09/2015 and smaller when compared to more remote studies.There is hypoenhancing lesion peripherally in the right hepatic lobe with overlying capsular retraction. This measures approximately 1.1 x 1.1 cm (series 801, image 333). There is surrounding arterial hyperenhancement, best appreciated on subtraction images which may reflect flow phenomenon however ongoing surveillance is recommended. There is adjacent perihepatic and intercostal fluid. There is capsular retraction overlying the left hepatic lobe with subtle confluent hyperenhancement, more obvious on delayed phases of imaging and suggestive of fibrosis. This may represent posttreatment changes. No discrete measurable lesion is identified.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.
1.Multiple liver lesions are again noted some of which demonstrate posttreatment changes. A peripheral right hepatic lobe lesion with overlying capsular retraction and surrounding arterial hyperenhancement requires ongoing close surveillance is active metastatic disease is not excluded.