Right renal tumor. Evaluate for right vein involvement and lymphadenopathy. Small left renal mass. ABDOMEN:LIVER, BILIARY TRACT: Several hepatic cysts. No suspicious liver lesion. Normally distended gallbladder without gallstones. No biliary ductal dilatation or vascular abnormality.SPLEEN: The spleen is normal in size without a focal lesion.PANCREAS: Moderate fatty filtration of the pancreatic head. No pancreatic ductal dilatation or focal lesion.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Lobular complex partially exophytic mass involving the superior half of the right kidney measuring 7.6 x 6.8 x 7.1 cm. No macroscopic fat. The lesion is peripherally isointense to the renal cortex on T2-weighted imaging with central nonenhancing probable necrosis. The lesion extends into the superior collecting system. It abuts the inferior aspect of the liver and extends into the pararenal fat. It abuts the renal vein without evidence of renal vein invasion. No enlarged locoregional lymphadenopathy.Mildly T2 hypointense enhancing endophytic lesion in the left interpolar region measures 2.9 x 2.4 x 2.4 cm. Few subcentimeter foci are too small to characterize, likely cysts. No hydronephrosis.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.
1.7.6 cm right exophytic and 2.9 cm left renal endophytic heterogeneous masses compatible with renal cell carcinoma. The right renal mass extends into the collecting system. It abuts the renal vein without evidence of invasion. No locoregional enlarged lymphadenopathy. The bilateral renal masses raises the possibility of Birt-Hogg-Dube Syndrome, particularly in patients with lung cysts. 2.Hepatic cysts. 