32-year-old female patient with tuberous sclerosis and angiomyolipomas. Evaluate response of angiomyolipoma with afinitor. ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis without evidence of acute cholecystitis. No intra or extra hepatic biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: The kidneys are enlarged and entirely replaced by fat containing lesions compatible with angiomyolipomas. No native parenchyma is definitively discerned. The kidneys as a whole measure approximately 23 cm on the left and 25 cm on the right in the craniocaudal dimension. They are significantly increased in size from 2006 study. For reference, an inferior component of the right angiomyolipoma measures approximately 12 cm in the craniocaudal dimension, previously 6 cm. There are interspersed T2 hyperintense cystic areas which may represent interspersed renal cysts or T2 bright components of the angiomyolipomas. Differentiation of different lesions within each kidney is difficult.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Marked levoscoliosis.OTHER: There is moderate ascites within the right hemiabdomen. There is an arcuate morphology of the uterus.
1.Enlarged, entirely replaced kidneys by angiomyolipomas with interspersed cystic components or renal cysts. These are significantly larger compared to 2006.2.Right abdominal ascites. 3.Cholelithiasis without evidence of cholecystitis. 