Male 48 years old with metastatic renal cancer, on everolimus, assess for progression. ABDOMEN:LIVER, BILIARY TRACT: The liver measures 18 cm in craniocaudal dimension. A few subcentimeter T2 hyperintensities are stable and most likely represent cysts. No new or suspicious hepatic lesion. No cholelithiasis, biliary ductal dilatation or ascites.SPLEEN: The spleen measures 10 cm in craniocaudal dimension.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post total resection of the left moiety and partial resection of the right moiety of the horseshoe/cross fused ectopic kidney. Mild soft tissue irregularity along the medial margin of the right lower pole (series 11, image 41) is stable and nonspecific but favored to reflect treatment changes. A cyst in the right lower pole adjacent to the resection margin has decreased in size.Anterior and inferior to the right renal vessels is in an amorphous area of enhancement and stranding seen best on subtraction images which, in retrospect, appears similar to the previous exam and may represent post treatment changes and fat necrosis (favored) although minimal residual tumor is not excluded. This is visibly improved when compared to the exam from 11/13/2015. There is nonspecific flow artifact versus adherent, nonenhancing thrombus in the IVC (series 9, image 412).RETROPERITONEUM, LYMPH NODES: The previously described mass abutting the third portion of the duodenum described on previous reports series is favored to represent a lymph node which has decreased in size measuring 2.0 x 1.1 cm (series 9, image 136).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Left basilar airspace opacity is new. Please refer to the separately dictated report for same day chest CT.
1.No discrete measurable tumor. When compared to most recent prior imaging, stable appearance of amorphous enhancement and stranding along the of the right kidney which is favored to represent posttreatment changes and fat necrosis, although small residual tumor is not excluded. Continued follow up recommended.2.Nonspecific flow artifact versus adherent, nonenhancing thrombus in IVC.3.No new sites of disease.