History of a new retroperitoneal mass measuring about 9 cm per outside hospital CT. Please characterize. LUNG BASES: Probable flow-phenomena artifact in the right atrium, without definite evidence of a filling defect to suggest thrombus. ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in morphology, size, signal intensity and enhancement without a focal suspicious lesion. No intra or extrahepatic biliary ductal dilatation. Normally distended gallbladder without gallstones. The vessels are patent. Punctate probable cyst in the anterior segment of the right hepatic lobe.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Retroperitoneal mass extending from the L3-4 intervertebral disc space inferiorly to the superior endplate of T12/level of the caudate with a predominant IVC intraluminal component which causes expansion of the vessel. The lesion abuts the orifice of the right and left renal veins without definite invasion, within the limitations of the exam. The extraluminal component abuts the aorta with mass effect on the right psoas muscle and draping over the adjacent vertebral bodies. Anteriorly there is mass effect on the pancreatic body without evidence of invasion. The mass measures approximately 9.2 cm in the craniocaudal dimension (series 7/23) and up to 4.7 x 3.9 cm in the axial dimension (series 8/26). The mass demonstrates heterogeneous enhancement with central necrosis.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Scoliosis.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Sigmoid diverticulosis without acute diverticulitis. Giant diverticulum at the anterior rectosigmoid junction.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Centrally necrotic retroperitoneal mass with a dominant expansile IVC intraluminal component most compatible with an IVC/retroperitoneal leiomyosarcoma. Other etiologies are considered less likely but include a malignant fibrous histiocytoma or malignant nerve sheath tumor. No evidence of distant metastatic disease.