37-year-old male with history of right nephrectomy complains of diffuse back pain. Urinalysis shows moderate blood. Fever. Rule out infected stone. ABDOMEN: This examination is limited by the absence of oral and intravenous contrast.LUNG BASES: Mild bibasilar dependent atelectatic changes. No acute infiltrates or effusions.LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: The left adrenal mass has increased in size and currently measures 4.6 x 6 cm and axial image 56/181.KIDNEYS, URETERS: Status post right nephrectomy. Minimal left perinephric fat stranding. No renal calculus. No hydronephrosis. There is a left posterior mid pole circumscribed hyper density at axial image 65/21 which measures approximately 2.7 cm in diameter. This was seen on the prior examination and may represent a hemorrhagic cyst or solid neoplasm. Characterization with intravenous contrast-enhanced CT or MRI exam may be helpful for further evaluation, if indicated.RETROPERITONEUM, LYMPH NODES: The retroperitoneal mass seen in the prior examination has increased in size and now measures 6.6 x 8.8 cm and axial image 93/181. There is extensive retroperitoneal lymphadenopathy, which was present on the prior examination, but has diffusely increased in size.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: There has been interval development of numerous retroperitoneal mass and left adrenal mass consistent with metastases.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
Interval increase in the retroperitoneal mass, lymphadenopathy, left adrenal mass. These findings are compatible with progression of known metastatic disease. No hydronephrosis. No nephrolithiasis.