76-year-old female with history of pancreatic head mass. ABDOMEN:LIVER, BILIARY TRACT: Multiple ring-enhancing T2 hyperintense lesions are seen scattered throughout the liver compatible with metastatic disease.Reference segment 2 lesion measures 2.3 x 2.2 cm (image 542 of series 1402).Reference segment 6 lesion measures 2.4 x 1.8 cm (image 357 of series 1402).Cholelithiasis.SPLEEN: No significant abnormality noted.PANCREAS: At the pancreatic head/body junction, there is a solid mass with intermediate T2 signal abnormality and persistent peripheral enhancement measuring 3.4 x 2.3 cm (image 362 of series 1402). There is significant downstream atrophy and pancreatic ductal dilatation. This lesion is intimately associated with the SMV and hepatic artery. The SMA, and splenic artery are uninvolved. The main portal and splenic veins are patent. Several prominent enhancing peripancreatic lymph nodes are present.There are additional smaller cystic lesion, for instance, located within the uncinate process measuring 13 x 12 mm (image 22 of series 601).ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral subcentimeter renal cysts, some of which are T1 hyperintense, likely representing a combination of hemorrhagic, proteinaceous, and/or simple cysts.A solid T1 hyperintense right interpolar lesion enhances avidly measures 16 x 16 mm (image 317 of series 1402).Additional exophytic right superior pole round lesion with decreased nodular peripheral signal measures 2.9 x 2.8 cm, and is nonspecific.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small right pleural effusion.
1. Findings consistent with primary pancreatic adenocarcinoma with liver metastases as above. The tumor is intimately associated with the proximal SMV and hepatic artery, however the remaining vessels appear patent. Reference measurements are provided.2. Right midpole enhancing renal lesion suspicious for neoplasm.