24-year-old with history of VHL and pancreatic cysts. ABDOMEN:LIVER, BILIARY TRACT: The liver appears normal in signal and morphology. The gallbladder is normal. There is no intra or extrahepatic biliary duct dilatation.SPLEEN: The spleen appears normal.PANCREAS: Innumerable cysts throughout the pancreatic parenchyma are again seen. The largest, reference lesion seen on the prior study is now not visualized. Multiple additional, smaller cysts seen on the prior study have also resolved. The largest cyst on the current study measures 32 x 20 mm in the pancreatic tail (series 9, image 18) with a thin septation and is unchanged. No enhancing, solid components are identified.ADRENAL GLANDS: The adrenal glands are normal.KIDNEYS, URETERS: Multiple, enhancing, solid/cystic lesions are noted in the right kidney. There is an 18 x 13 mm septated, enhancing lesion in the mid right renal pole (series 1602, image 42), previously 14 x 12 mm. Additionally, there is an enhancing mass in the right lower renal pole (series 1602, image 51) which avidly enhances and measures 14 x 9 mm, previously 11 x 7 mm. Additional renal cysts are seen bilaterally. Renal veins appear normal.RETROPERITONEUM, LYMPH NODES: No significant lymphadenopathy noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: T2 hyperintensity within the central spinal cord in the lower thoracic spine is again noted.OTHER: No significant abnormality noted.
1.Two enlarging heterogeneously enhancing right renal lesions highly suspicious for renal cell carcinoma.2.Stable and decreased size of pancreatic cysts as above.