Metastatic renal carcinoma. Evaluate level for tumor thrombus. ABDOMEN:LIVER, BILIARY TRACT: No focal liver lesion is identified. There is mass effect on the liver by right renal mass.SPLEEN: Metastatic disease involving left posterior thoracic ribs extends to level of left hemidiaphragm/possibly touches posterior aspect of the splenic capsule.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: The right adrenal gland is probably engulfed by the right renal mass. The left adrenal gland is unremarkable.KIDNEYS, URETERS: The right kidney measures 12.6 x 9.4 cm and is replaced by tumor. Tumor obliterates the right renal vein, enlarges the IVC and extends to the level of the inferior cavoatrial junction (series 23, image 34). The left kidney is unremarkable.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is a T2 hyperintense 1.1 cm peritoneal nodule in the left anterior abdomen, consistent with peritoneal implant (series 13, image 8).BONES, SOFT TISSUES: Large osseous metastases involving lower left thoracic ribs measuring 12.1 x 5.3 cm in largest dimension, with extension into the spinal canal, best seen on series 20, image 95. Please refer to bone scan performed January 21, 2016 for additional information.OTHER: Trace left pleural effusion. There is indentation of the left diaphragm.
1.Renal cell carcinoma largely replaces the right kidney with IVC invasion extending to the inferior cavoatrial junction.2.Peritoneal and osseous metastases. Extension into the spinal canal, may be better evaluated with dedicated thoracic spine MRI.