Liver lesions. Stated history of hepatocellular carcinoma status post TACE/RFA of segment 5 and segment 7/8 (8/11/2014 at OSH). Per EPIC note: Segment 7/8 was HCC; Segment 5 CCA. History of Wilms tumor status post radical right nephrectomy. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology with nodular contour and areas of fibrosis.Segment 5 ablation cavity measuring 2.0 x 1.9 cm (series 11/124) with internal blood products/hemorrhage. Along the anteroinferior margin of the ablation cavity there is arterial enhancement measuring 1.9 x 1.5 cm. This does not appear to progress on delayed imaging or wash-out but rather persists or is iso-intense to the liver parenchyma. There is no definite associated DWI or T2WI signal abnormality. Segment 7/8 radiofrequency ablation cavity measures 2.2 x 1.3 cm (series 11/24). No evidence of residual or recurrent tumor.Several peripheral punctate foci of arterial enhancement without associated washout or other signal abnormality are unchanged and are likely perfusional abnormalities.No new suspicious lesion. The vessels are patent.Normally distended gallbladder. Stable minimal peripheral biliary ductal dilatation of the inferior medial segment of the left hepatic lobe. SPLEEN: The spleen measures 10 cm in length without a focal lesion.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Minimal adrenal nodularity measuring less than 1 cm, unchanged.KIDNEYS, URETERS: Status post right nephrectomy without evidence of residual or recurrent disease in the surgical bed. Subcentimeter left inferior pole simple appearing cyst is unchanged. No hydroureteronephrosis or suspicious lesion.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.
1.Arterial enhancement along the anteroinferior margin of the segment V RFA cavity does not appear to progress on delayed imaging or wash-out but rather persist or is iso-intense. There is no definite associated DWI or T2WI signal abnormality. Given that this lesion was reportedly a cholangiocarcinoma residual/marginal recurrent disease cannot be excluded although a perfusional abnormality is a possibility. Short interval follow-up is recommended if definitive evaluation (biopsy) or treatment is not pursued at this time. 2.Segment 7/8 ablation cavity without evidence of residual or recurrent tumor.3.Cirrhosis with mild fibrotic changes. 