History of liver mass seen on CT. ABDOMEN:LIVER, BILIARY TRACT: The liver demonstrates normal morphology and background parenchymal signal intensityThere is a large, lobulated and sharply marginated, encapsulated mass centered in hepatic segment 4a also extending into segments 2 and 8 with reference measurements below. The mass demonstrates heterogeneous increased T2 signal, decreased T1 signal, restricted diffusion, and no evidence of intralesional fat. The lesion demonstrates heterogeneous enhancement with suggestion of filling in on more delayed images. No definite washout is seen. There is a subcentimeter T2 hyperintense nonenhancing lesion within the anterior inferior aspect of hepatic segment 2 compatible with a cyst. No additional focal hepatic lesions are identified.There is attenuation/obstruction of the hepatic vessels traversing the mass, including the middle hepatic vein. The main portal vein and proximal branches appear patent.The gallbladder is nondistended. No intra or extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Several scattered subcentimeter cysts.RETROPERITONEUM, LYMPH NODES: There are 2 abnormally enlarged cardiophrenic lymph nodes, increased in size from prior with reference measurements belowBOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: There is a enhancing, spiculated mass within the right breast which is suspicious for malignancy with reference measurements as below.OTHER: No significant abnormality noted.INDEX LESION MEASUREMENTS (Current exam date/time: 9/14/2016 10:15:00)LEFT HEPATIC LESION : 9.2 x 8.1 cm (Image 12, Series 4); 8.1 cm (Image 15, Series 6); 6.2 x 6.0 cm on prior (5/17/2016) (Image 18, Series 80376).RIGHT BREAST LESION: 1.6 x 1.5 cm (Image 8, Series 9).CARDIOPHRENIC LYMPH NODE: 1.2 x 0.9 cm (Image 18, Series 9); 0.9 x 0.6 cm on prior (5/17/2016) (Image 12, Series 80376).
1.Hepatic mass highly suspicious for neoplasm, increased in size compared to 5/17/2016 CT. Differential considerations include cholangiocarcinoma, hepatocellular carcinoma, mixed tumor, or less likely solitary metastasis. Associated cardiophrenic lymphadenopathy.2.Enhancing right breast mass suspicious for neoplasm. Dedicated breast imaging and workup is recommended if not recently performed.