Female 63 years old Reason: Patient with large right renal mass. Eval for IVC involvement and surgical planning History: as above ABDOMEN:LIVER, BILIARY TRACT: Liver is normal in morphology. There is fatty infiltration of the liver. No suspicious hepatic lesions. Hepatic and portal veins are patent. Gallbladder is mildly distended.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: There is a large right anterior renal enhancing mass measuring 9.6 x 7.8 cm (image 294/series 1404) . Enhancing tumor thrombus extends into the renal vein and into the IVC . Tumor thrombus extends to the level of the L1 and L2 vertebral bodies. The intrahepatic IVC appears free of thrombus.The mass contacts the lateral aspect of the second portion of the duodenum with loss of the fat plane.There is extension into the perinephric fat. The mass also abuts the inferior aspect of the liver with a thin fat plane between the mass and the liver edge.There is hemorrhage in the right renal collecting system.No focal mass in the left kidney.RETROPERITONEUM, LYMPH NODES: Small aortocaval lymph nodes with a reference lymph node measuring 0.9 x 0.7 cm (image 16/series 1101). BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Foley catheter noted within the urinary bladder.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.Right renal mass with tumor thrombus extension into the IVC.2.The renal mass abuts the second portion of the duodenum with loss of a fat plane.