63-year-old female patient with history of colon cancer presents for preoperative planning. ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy. No intra or extrahepatic biliary ductal dilatation. No suspicious enhancing lesions.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Complex cystic lesion with enhancing thick septations and solid components measures 5.3 x 5.4 x 3.9 cm (series 801 image 26 and series 501 image 27) in the left kidney. No evidence of renal vein invasion.RETROPERITONEUM, LYMPH NODES: Small retroperitoneal lymph nodes.BOWEL, MESENTERY: Small hiatal hernia.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: There are numerous bilateral prominent lymph nodes in the pelvis. For reference, a left external iliac lymph node measures 1.5 x 1.2 cm (series 1602 image 53).BOWEL, MESENTERY: There is an eccentrically located mass that appears to be arising from the sigmoid colon that measures 8.1 x 6.9 x 6.6 cm (series 1502 image 53 and series 1302 image 14) that is heterogenously enhancing with central necrosis. There is loss of the fat plane between the mass and the uterus posteriorly as well as invasion into the bladder dome. Additionally, the lesion appears to invade into the left rectus abdominis muscle. There is thickening of the sigmoid colon that the lesion appears to be arising from.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Mass that appears to be arising from the sigmoid colon with invasion into the bladder, to the uterus, and anterior abdominal wall. Enlarged pelvic lymph nodes.2.Mass in the left kidney most compatible with renal cell carcinoma with small retroperitoneal lymph nodes without evidence of renal vein invasion.