65-year-old male. Metastatic renal cancer on chemotherapy presenting for staging CT found to have interloop abscess status post IR drainage. MRI abdomen/pelvis to evaluate for any renal cell cancer deposits. Evaluate for intraperitoneal renal cell carcinoma deposits. ABDOMEN:LUNG BASES: Small bilateral pleural effusions. Left sixth rib soft tissue metastasis (series 1001, image 284).LIVER, BILIARY TRACT: No suspicious hepatic mass. No biliary ductal dilatation.SPLEEN: Diffusely decreased T2 signal of the spleen with signal loss on in phase images consistent with iron deposition.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: A large heterogeneously enhancing mass in the right upper pole of the horseshoe kidney measures 9.2 x 8.7 cm (series 1001, image 361), consistent with known renal cell carcinoma. A few cysts in the left pole.RETROPERITONEUM, LYMPH NODES: Moderately enlarged mesenteric lymph nodes.BOWEL, MESENTERY: Diffuse wall thickening of right lower quadrant terminal ileum bowel loops with associated mesenteric stranding and enteroenteric fistulas. Rim enhancing pocket of fluid immediately lateral to the small bowel is 3.8 x 3.5 cm, consistent with an abscess. Small bowel loop tethered to the cecum likely represents a enterocolic fistula (series 1401, image 4). Right lower quadrant drain is seen entering the abdomen; intraabdominal portion is not well-visualized due to technique. No discrete small bowel mass or serosal deposits are evident, though evaluation is limited due to underdistention.Colonic diverticulosis. BONES, SOFT TISSUES: L4 vertebral level metastasis.OTHER: No significant abnormality noted.
1.Terminal ileal loops with wall thickening and multiple enteroenteric fistulas and likely an enterocolic fistula. Rim enhancing pocket of fluid lateral to these abnormal loops consistent with an abscess. 2.No discrete small bowel mass or serosal deposits are evident.3.Right upper pole renal mass consistent with known renal cell carcinoma with metastatic disease, as described above.