Female 51 years old Reason: History metastatic renal cancer, assess for progression ABDOMEN:LIVER, BILIARY TRACT: The liver is enlarged secondary to innumerable rim enhancing, T2 hyperintense, diffusion restricting lesions which are consistent with metastatic disease. The reference lesion anterior to the IVC in the right hepatic lobe measures 2.9 x 2.5 cm (series 3, image 14), previously 1.4 x 1.3 cm demonstrating an interval increase in size. Additional non reference lesions are also subjectively increased in size. SPLEEN: Signal drop out within the spleen on in phase images, again suggesting iron deposition.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post right nephrectomy. T2 hyperintense lesion within the left kidney is consistent with a renal cyst.RETROPERITONEUM, LYMPH NODES: The intrahepatic-IVC is attenuated, secondary to mass effect from adjacent metastatic deposits. Prominent gastrohepatic, retroperitoneal and juxtaphrenic lymph nodes demonstrate an internal increase in size suggestive of worsening metastatic disease.BOWEL, MESENTERY: Small hiatal hernia.BONES, SOFT TISSUES: No significant abnormality noted.
1.Hepatomegaly with diffuse hepatic metastatic deposits, significantly increased in size compared to prior study.2.Increasing gastrohepatic, retroperitoneal and juxtaphrenic nodes suggesting worsening metastatic disease.3.Post surgical changes of right nephrectomy without evidence of recurrent disease in the nephrectomy bed.