Left breast lumpectomy for an ADC. Now presents with recurrent right chest wall moderately differentiated adenocarcinoma. Pay particular attention to right anterior lateral chest wall mass and metastatic workup. CHEST:LUNGS AND PLEURA: One mild interstitial opacity in the right apex and in the subpleural left anterior chest consistent with scarring.MEDIASTINUM AND HILA: Small thyroid cyst in the left lobe.Moderately enlarged lower right paratracheal lymph node with a short axis measurement of 18 mm.Extensive and severe coronary artery calcification.CHEST WALL: Focal enhancing nodular lesion in the subcutaneous tissues of the right anterior chest wall at the level of the clavicle on image 17/140 measuring 10 x 18 mm, consistent with a metastasis.Low density, probably necrotic lymph node, best seen on the coronal sections on image 59/119, measuring 14 x 26 mm.Right Mammoplasty.Surgical clips in the left breast and skin thickening.Kyphosis with associated degenerative disease but no visible skeletal metastases.ABDOMEN:LIVER, BILIARY TRACT: Multiple well-defined hypodense hepatic lesions compatible with cysts, and a large partially loculated lesion with slightly ill-defined margins measuring 27 x 37 mm on image 73/40.. This may represent an atypical cyst but further imaging with PET or MRI would be necessary to exclude a metastasis with confidence.Moderate dilation of intrahepatic ducts.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Nodular enlargement of the right adrenal gland measuring 16 x 18 mm on image 84/140.KIDNEYS, URETERS: Multiple bilateral renal cysts.PANCREAS: Multiple large cysts in the head, body and tail of the pancreas of uncertain etiology, possibly due to intraductal capillary mucinous neoplasms , though probably benign.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. Enhancing subcutaneous lesion in the right anterior chest wall with a locally necrotic enlarged lymph node, consistent with metastases.2. Additional indeterminate abnormalities in the abdomen as detailed above.